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General NPI Number Information
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NPI Number | 1649409905
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Entity Type | Organization
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Legal Business Name | SPORTS ORTHOPEDIC AND REHABILITATION MEDICINE ASSOCIATES
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 11/23/2009
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Provider Practice Location Address
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Address Line | 550 S WINCHESTER BLVD
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City | SAN JOSE
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State | CA
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Zip | 95128-2544
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Country | US
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Telephone | 408-247-4900
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Fax | 650-995-1202
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Provider Business Mailing Address
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Address Line | 550 S WINCHESTER BLVD
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City | SAN JOSE
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State | CA
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Zip | 95128-2544
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Country | US
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Telephone | 408-247-4900
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Fax | 650-995-1202
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | KAREN SOLLAR
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Credential |
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Telephone | 650-851-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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