Healthcare Provider Details

I. General information

NPI: 1780915744
Provider Name (Legal Business Name): LOS ANGELES ORTHOPEDIC GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2010
Last Update Date: 04/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5257 PARAMOUNT BLVD
LAKEWOOD CA
90712-2121
US

IV. Provider business mailing address

5257 PARAMOUNT BLVD
LAKEWOOD CA
90712-2121
US

V. Phone/Fax

Practice location:
  • Phone: 562-633-0809
  • Fax: 562-633-0857
Mailing address:
  • Phone: 562-633-0809
  • Fax: 562-633-0857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: RAUL BARRIGUETE ORTIZ
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 562-633-0809