Provider Demographics
NPI:1982968954
Name:FIXYOU ORTHO, LLC
Entity Type:Organization
Organization Name:FIXYOU ORTHO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:VISMANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-920-0991
Mailing Address - Street 1:1345 MORAGA DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-1647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1345 MORAGA DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-1647
Practice Address - Country:US
Practice Address - Phone:310-920-0991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center