Healthcare Provider Details

I. General information

NPI: 1356836993
Provider Name (Legal Business Name): CALIFORNIA ORTHOPEDICS & SPINE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 BON AIR RD STE 129
LARKSPUR CA
94939-1139
US

IV. Provider business mailing address

18 BON AIR RD
LARKSPUR CA
94939-1123
US

V. Phone/Fax

Practice location:
  • Phone: 415-924-8900
  • Fax: 415-924-7149
Mailing address:
  • Phone: 415-927-5300
  • Fax: 415-927-6860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL OECHSEL
Title or Position: CFO
Credential: MD
Phone: 415-927-5300