Healthcare Provider Details

I. General information

NPI: 1013206176
Provider Name (Legal Business Name): TRI STAR ORTHOPAEDICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2011
Last Update Date: 05/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 SHATTO PL STE 208
LOS ANGELES CA
90020-1836
US

IV. Provider business mailing address

440 SHATTO PL STE 208
LOS ANGELES CA
90020-1836
US

V. Phone/Fax

Practice location:
  • Phone: 213-382-2030
  • Fax: 866-438-5974
Mailing address:
  • Phone: 213-382-2030
  • Fax: 866-438-5974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC22101
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC13472
License Number StateCA

VIII. Authorized Official

Name: CHRISTOPHER T. ARMSTRONG
Title or Position: PRESIDENT
Credential: DC
Phone: 213-382-2030