Healthcare Provider Details

I. General information

NPI: 1659473171
Provider Name (Legal Business Name): ORTHOPAEDIC ASSOC MEDICAL CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 S AKERS 220
VISALIA CA
93277-8309
US

IV. Provider business mailing address

PO BOX 2632
VISALIA CA
93279-2632
US

V. Phone/Fax

Practice location:
  • Phone: 559-625-0551
  • Fax: 559-733-4475
Mailing address:
  • Phone: 559-625-0551
  • Fax: 559-733-4475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE5270
License Number StateCA

VIII. Authorized Official

Name: KIM HINOJOS
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 559-733-3346