Provider Demographics
NPI:1356722177
Name:WEST COAST ORTHOPEDICS
Entity type:Organization
Organization Name:WEST COAST ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-287-3231
Mailing Address - Street 1:2700 N. MAIN ST #400
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-6602
Mailing Address - Country:US
Mailing Address - Phone:949-287-3231
Mailing Address - Fax:714-916-5733
Practice Address - Street 1:2700 N MAIN ST
Practice Address - Street 2:#400
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-6634
Practice Address - Country:US
Practice Address - Phone:949-287-3231
Practice Address - Fax:714-916-5733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85057207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty