MEDICARE: WESTERN SIERRA ORTHOPAEDIC CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	G50528	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457393639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN SIERRA ORTHOPAEDIC CENTER INC

Provider Business Mailing Address
First Line	:	4300 GOLDEN CENTER DR
Second Line	:	SUITE C
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-6278
Country	:	US
Telephone Number	:	530-344-2070
Fax Number	:	530-295-0400

Provider Business Practice Location Address
First Line	:	4300 GOLDEN CENTER DR
Second Line	:	SUITE C
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-6278
Country	:	US
Telephone Number	:	530-344-2070
Fax Number	:	530-295-0400

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	JACKIE PABST
Credential	:
Telephone Number	:	530-344-2070

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	12/22/2010

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Directions to “WESTERN SIERRA ORTHOPAEDIC CENTER INC ” Practice Location

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