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General NPI Number Information
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NPI Number | 1376343079
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Entity Type | Organization
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Legal Business Name | ORTHOSPINE SPECIALISTS A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 2400 SAMARITAN DR STE 100
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City | SAN JOSE
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State | CA
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Zip | 95124-3910
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Country | US
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Telephone | 831-204-6495
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Fax |
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Provider Business Mailing Address
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Address Line | 56B 5TH ST UNIT 3892
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City | CARMEL BY THE SEA
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State | CA
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Zip | 93921-8181
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Country | US
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Telephone | 831-204-6495
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KRIS OKUMU
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Credential | MD
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Telephone | 831-204-6495
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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 |
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License Number State |
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