Healthcare Provider Details

I. General information

NPI: 1689632374
Provider Name (Legal Business Name): ORTHOPAEDIC HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 WEST ADAMS BLVD.
LOS ANGELES CA
90007
US

IV. Provider business mailing address

403 W ADAMS BLVD
LOS ANGELES CA
90007-2664
US

V. Phone/Fax

Practice location:
  • Phone: 213-742-1104
  • Fax: 213-742-1435
Mailing address:
  • Phone: 213-742-1104
  • Fax: 213-742-1435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number550000083
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number550000083
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: JAMIE WELLS
Title or Position: CHIEF OPERATIONS OFFICER
Credential: COO
Phone: 213-742-1009