Healthcare Provider Details

I. General information

NPI: 1942300918
Provider Name (Legal Business Name): ORTHOPAEDIC HOSPITAL MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 05/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W ADAMS BLVD
LOS ANGELES CA
90007-2664
US

IV. Provider business mailing address

403 W ADAMS BLVD ADMINISTRATION
LOS ANGELES CA
90007-2664
US

V. Phone/Fax

Practice location:
  • Phone: 213-742-1000
  • Fax: 213-742-1435
Mailing address:
  • Phone: 213-742-1369
  • Fax: 213-742-1435

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 Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY SCADUTO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 213-742-1120