Healthcare Provider Details

I. General information

NPI: 1801073978
Provider Name (Legal Business Name): ORTHOPEDIC CENTER FOR EXCELLENCE MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 01/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21530 PIONEER BLVD
HAWAIIAN GARDENS CA
90716-2608
US

IV. Provider business mailing address

21350 HAWTHORNE BLVD SUITE 274
TORRANCE CA
90503-5605
US

V. Phone/Fax

Practice location:
  • Phone: 310-540-3145
  • Fax: 310-540-2306
Mailing address:
  • Phone: 310-540-3145
  • Fax: 310-540-2306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number207X00000X
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number207XS011X
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES SADAO HAMADA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-540-3145