Provider Demographics
NPI:1922534445
Name:CUTTING EDGE ORTHOPEDICS INC
Entity Type:Organization
Organization Name:CUTTING EDGE ORTHOPEDICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARDINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-360-6784
Mailing Address - Street 1:1717 E VISTA CHINO STE A7-492
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-3559
Mailing Address - Country:US
Mailing Address - Phone:760-360-6784
Mailing Address - Fax:
Practice Address - Street 1:74000 COUNTRY CLUB DR
Practice Address - Street 2:SUITE G3
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-1685
Practice Address - Country:US
Practice Address - Phone:760-360-6784
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116351207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty