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General NPI Number Information
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NPI Number | 1467563007
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Entity Type | Organization
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Legal Business Name | TRI-VALLEY ORTHOPEDIC SPORTS AND MEDICAL GROUP INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 87 FENTON ST SUITE 105
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City | LIVERMORE
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State | CA
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Zip | 94550-4100
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Country | US
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Telephone | 925-373-9182
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Fax | 925-373-2493
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Provider Business Mailing Address
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Address Line | 4626 WILLOW RD SUITE 200
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City | PLEASANTON
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State | CA
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Zip | 94588-2710
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Country | US
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Telephone | 925-469-0939
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Fax | 925-469-0165
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Authorized Official
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Title or Position | BILLING DEPARTMENT MANAGER
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Name | DEBORAH RHOTON
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Credential |
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Telephone | 925-469-0939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand 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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