Healthcare Provider Details

I. General information

NPI: 1558296921
Provider Name (Legal Business Name): ORTHO SOCAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12215 TELEGRAPH RD STE 112
SANTA FE SPRINGS CA
90670-3344
US

IV. Provider business mailing address

12215 TELEGRAPH RD STE 112
SANTA FE SPRINGS CA
90670-3344
US

V. Phone/Fax

Practice location:
  • Phone: 562-548-2230
  • Fax: 562-654-6895
Mailing address:
  • Phone: 562-548-2230
  • Fax: 562-654-6895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: KEVIN J PELTON
Title or Position: PRESIDENT
Credential: MD
Phone: 562-548-2230