Healthcare Provider Details

I. General information

NPI: 1285594804
Provider Name (Legal Business Name): ORTHO SPINE AND SPORTS MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2025
Last Update Date: 11/15/2025
Certification Date: 11/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5475 E LA PALMA AVE STE 204
ANAHEIM CA
92807-2075
US

IV. Provider business mailing address

77 CARTWHEEL
IRVINE CA
92618-1708
US

V. Phone/Fax

Practice location:
  • Phone: 657-331-9064
  • Fax: 657-331-7935
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTO FRITZ
Title or Position: PRESIDENT
Credential: MD
Phone: 925-785-0826