Healthcare Provider Details

I. General information

NPI: 1689870743
Provider Name (Legal Business Name): UCLA DEPT OF ORTHOPAEDIC SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 16TH ST SUITE 744
SANTA MONICA CA
90404-1249
US

IV. Provider business mailing address

1250 16TH ST SUITE 744
SANTA MONICA CA
90404-1249
US

V. Phone/Fax

Practice location:
  • Phone: 310-319-4282
  • Fax:
Mailing address:
  • Phone: 310-319-4282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License NumberPA15177
License Number StateCA

VIII. Authorized Official

Name: DR. DANIEL A OAKES
Title or Position: CHIEF, ARTHROPLASTY SERVICE
Credential: M.D.
Phone: 310-319-4257