Healthcare Provider Details

I. General information

NPI: 1154721900
Provider Name (Legal Business Name): WESTERN ORTHOPAEDIC GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2014
Last Update Date: 08/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13120 PHILADELPHIA ST
WHITTIER CA
90601-4301
US

IV. Provider business mailing address

13120 PHILADELPHIA ST
WHITTIER CA
90601-4301
US

V. Phone/Fax

Practice location:
  • Phone: 888-418-6244
  • Fax: 562-698-8884
Mailing address:
  • Phone: 888-418-6244
  • Fax: 562-698-8884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberDC 22101
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE1174
License Number StateCA

VIII. Authorized Official

Name: DR. FRANK J GAROFALO
Title or Position: CEO
Credential: DPM
Phone: 888-418-6244