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General NPI Number Information
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NPI Number | 1154834190
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Entity Type | Organization
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Legal Business Name | TORRANCE ORTHOPAEDIC AND SPORTS MEDICINE GROUP
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Dates
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Enumeration Date | 11/13/2017
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Last Update Date | 07/15/2020
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Provider Practice Location Address
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Address Line | 5215 TORRANCE BLVD STE 210
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City | TORRANCE
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State | CA
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Zip | 90503-4009
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Country | US
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Telephone | 310-316-6190
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Fax |
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Provider Business Mailing Address
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Address Line | 5215 TORRANCE BLVD STE 210
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City | TORRANCE
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State | CA
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Zip | 90503-4009
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Country | US
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Telephone | 310-316-6190
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Fax | 310-540-7362
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATIVE
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Name | CARRIE KILLEN
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Credential |
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Telephone | 310-316-6190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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