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General NPI Number Information
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NPI Number | 1215122049
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Entity Type | Organization
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Legal Business Name | USC ORTHOPAEDIC SURGERY ASSOCIATES, INC.
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 09/14/2007
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Provider Practice Location Address
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Address Line | 1520 SAN PABLO ST 200
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City | LOS ANGELES
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State | CA
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Zip | 90033-5310
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Country | US
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Telephone | 323-442-5881
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Fax | 323-442-6978
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Provider Business Mailing Address
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Address Line | PO BOX 1162
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City | LOS ANGELES
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State | CA
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Zip | 90084-0001
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Country | US
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Telephone | 323-442-5881
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Fax | 323-442-6978
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Authorized Official
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Title or Position | MEDICAL DIRCTOR
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Name | DR. MICHAEL J. PATZAKIS
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Credential | MD
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Telephone | 323-442-5881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | A71130
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License Number State | CA
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