Healthcare Provider Details

I. General information

NPI: 1093740748
Provider Name (Legal Business Name): JOHN E STRATTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23456 HAWTHORNE BLVD SUITE 300
TORRANCE CA
90505-4716
US

IV. Provider business mailing address

23456 HAWTHORNE BLVD SUITE 300
TORRANCE CA
90505-4716
US

V. Phone/Fax

Practice location:
  • Phone: 310-316-6190
  • Fax: 310-540-7362
Mailing address:
  • Phone: 310-316-6190
  • Fax: 310-540-7362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberA21293
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: