Healthcare Provider Details

I. General information

NPI: 1689851693
Provider Name (Legal Business Name): ORTHOPEDIC CENTER FOR EXCELLENCE MEDICAL GROUP A MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 05/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 NO VERMONT AVENUE SUITE 710 DOCTORS TOWER
LOS ANGELES CA
90027
US

IV. Provider business mailing address

21350 HAWTHORNE BLVD SUITE 274
TORRANCE CA
90503
US

V. Phone/Fax

Practice location:
  • Phone: 323-913-4380
  • Fax: 323-913-4381
Mailing address:
  • Phone: 310-540-3145
  • Fax: 310-540-2306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberC30470
License Number StateCA

VIII. Authorized Official

Name: JAMES SADAD HAMADA
Title or Position: PRESIDENT
Credential: MD
Phone: 310-540-3145