Healthcare Provider Details
I. General information
NPI: 1285974725
Provider Name (Legal Business Name): CENTER FOR HIP PRESERVATION AND CHILDREN'S ORTHOPAEDICS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2013
Last Update Date: 02/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2023 W VISTA WAY SUITE B
VISTA CA
92083-6030
US
IV. Provider business mailing address
23052 ALICIA PKWY # 619
MISSION VIEJO CA
92692-1643
US
V. Phone/Fax
- Phone: 760-726-5800
- Fax: 760-726-5942
- Phone: 714-808-9797
- Fax: 714-808-9393
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XP3100X |
| Taxonomy | Pediatric Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HARISH
SADANAND
HOLSALKAR
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 760-726-5800