Provider Demographics
NPI:1649433962
Name:CALIFORNIA SPORTS AND ORTHOPAEDIC
Entity type:Organization
Organization Name:CALIFORNIA SPORTS AND ORTHOPAEDIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:EPPLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-704-7760
Mailing Address - Street 1:2999 REGENT ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2190
Mailing Address - Country:US
Mailing Address - Phone:510-704-7760
Mailing Address - Fax:510-704-7765
Practice Address - Street 1:25 ORINDA WAY
Practice Address - Street 2:SUITE 100-A
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-4403
Practice Address - Country:US
Practice Address - Phone:925-258-9571
Practice Address - Fax:925-258-9572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63226207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty