Provider Demographics
NPI:1205176005
Name:LOS ANGELES CENTER FOR ORTHOPEDICS
Entity type:Organization
Organization Name:LOS ANGELES CENTER FOR ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONTIVEROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-588-1993
Mailing Address - Street 1:880 S ATLANTIC BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-4700
Mailing Address - Country:US
Mailing Address - Phone:626-588-1993
Mailing Address - Fax:626-308-2083
Practice Address - Street 1:880 S ATLANTIC BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-4700
Practice Address - Country:US
Practice Address - Phone:626-588-1993
Practice Address - Fax:626-308-2083
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE ZAPANTA SAUCEDO MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37089174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty