Healthcare Provider Details
I. General information
NPI: 1770542367
Provider Name (Legal Business Name): TRI CITY ORTHOPAEDIC SURGERY MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/21/2006
Last Update Date: 03/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6121 PASEO DEL NORTE SUITE 200
CARLSBAD CA
92011-1159
US
IV. Provider business mailing address
3905 WARING RD
OCEANSIDE CA
92056-4405
US
V. Phone/Fax
- Phone: 760-724-9000
- Fax: 760-724-9000
- Phone: 760-724-9000
- Fax: 760-724-3686
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
NEVILLE
ALLEYNE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 760-724-9000