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General NPI Number Information
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NPI Number | 1518208081
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Entity Type | Organization
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Legal Business Name | SOUTHERN CALIFORNIA ORTHOPEDIC INSTITUTE, LP
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Dates
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Enumeration Date | 03/08/2013
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Last Update Date | 10/04/2016
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Provider Practice Location Address
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Address Line | 2400 BAHAMAS DR
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0745
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Country | US
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Telephone | 661-328-5565
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Fax | 661-328-5573
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Provider Business Mailing Address
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Address Line | 2400 BAHAMAS DR
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City | BAKERSFIELD
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State | CA
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Zip | 93309-0745
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Country | US
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Telephone | 661-328-5565
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Fax | 661-328-5573
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | TODD D. MOLDAWER
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Credential | MD
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Telephone | 818-901-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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