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General NPI Number Information
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NPI Number | 1356061949
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Entity Type | Organization
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Legal Business Name | OAK TREE ORTHOPEDICS INC
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Dates
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Enumeration Date | 09/01/2022
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Last Update Date | 04/03/2024
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Provider Practice Location Address
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Address Line | 800 MAGNOLIA AVE STE 102
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City | CORONA
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State | CA
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Zip | 92879-3123
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Country | US
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Telephone | 657-235-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 2710 N BENTLEY ST
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City | ORANGE
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State | CA
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Zip | 92867-2258
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Country | US
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Telephone | 657-235-9355
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NASSER HEYRANI
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Credential | MD
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Telephone | 657-235-9355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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