Healthcare Provider Details

I. General information

NPI: 1780666446
Provider Name (Legal Business Name): ARTHRITIS ORTHOPEDIC AND SPORTS MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 WILSON TER SUITE 200
GLENDALE CA
91206-4071
US

IV. Provider business mailing address

1505 WILSON TER SUITE 200
GLENDALE CA
91206-4071
US

V. Phone/Fax

Practice location:
  • Phone: 818-246-8974
  • Fax: 818-246-7673
Mailing address:
  • Phone: 818-246-8974
  • Fax: 818-246-7673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberG46741
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT27963
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberG64893
License Number StateCA

VIII. Authorized Official

Name: DR. CARLO ANTHONY ORLANDO
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 818-246-8974