Healthcare Provider Details

I. General information

NPI: 1548403959
Provider Name (Legal Business Name): CALIFORNIA ORTHOPEDIC INSTITUTE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2009
Last Update Date: 03/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 S. GRAND AVE #208
LOS ANGELES CA
90015
US

IV. Provider business mailing address

P.O. BOX 4029
CERRITOS CA
90703
US

V. Phone/Fax

Practice location:
  • Phone: 213-765-8088
  • Fax: 213-765-8181
Mailing address:
  • Phone: 213-765-8088
  • Fax: 213-765-8181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License NumberA78259
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberA78259
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA78259
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License NumberA78259
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberA78259
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License NumberA78259
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberA78259
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberA78259
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberA78259
License Number StateCA
# 10
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberA78259
License Number StateCA
# 11
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberA78259
License Number StateCA
# 12
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberA78259
License Number StateCA

VIII. Authorized Official

Name: DR. GARY Y CHEN, M.D
Title or Position: PRESIDENT
Credential: ORTHOPEDIC SURGEON
Phone: 562-547-6241