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General NPI Number Information
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NPI Number | 1609916923
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Entity Type | Organization
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Legal Business Name | SPINE CARE & ORTHOPEDIC PHYSICIANS
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 8610 S SEPULVEDA BLVD SUITE #109
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City | LOS ANGELES
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State | CA
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Zip | 90045-4008
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Country | US
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Telephone | 310-337-3700
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Fax | 310-337-0947
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Provider Business Mailing Address
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Address Line | 8610 S SEPULVEDA BLVD SUITE #109
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City | LOS ANGELES
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State | CA
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Zip | 90045-4008
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Country | US
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Telephone | 310-337-3700
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Fax | 310-337-0947
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | DR. ROBERT T MIN
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Credential | D.C.
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Telephone | 310-337-3700
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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 | G31730
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License Number State | CA
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