Healthcare Provider Details

I. General information

NPI: 1447899752
Provider Name (Legal Business Name): PASADENA ORTHOPEDICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2020
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

959 E WALNUT ST STE 220
PASADENA CA
91106-5363
US

IV. Provider business mailing address

PO BOX 70422
PASADENA CA
91117-7422
US

V. Phone/Fax

Practice location:
  • Phone: 626-517-0022
  • Fax:
Mailing address:
  • Phone: 909-226-4040
  • Fax: 213-266-8183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ANNETTE BILLINGS
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 626-517-0022