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General NPI Number Information
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NPI Number | 1497816011
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC TRAUMA SOLUTIONS INC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 04/16/2014
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Provider Practice Location Address
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Address Line | 2662 EDITH AVE
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City | REDDING
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State | CA
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Zip | 96001
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Country | US
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Telephone | 530-242-1266
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Fax | 530-243-4205
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Provider Business Mailing Address
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Address Line | 2662 EDITH AVE
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City | REDDING
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State | CA
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Zip | 96001
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Country | US
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Telephone | 530-242-1266
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Fax | 530-243-4205
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LISA R VANDEBURG
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Credential |
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Telephone | 530-242-1266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 20A9141
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | 20A9141
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License Number State | CA
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