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General NPI Number Information
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NPI Number | 1699909531
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Entity Type | Organization
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Legal Business Name | PACIFIC ORTHOPEDIC AND REHABILITATION MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 05/06/2009
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Provider Practice Location Address
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Address Line | 5301 WHITTIER BLVD 4TH FLOOR
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City | LOS ANGELES
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State | CA
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Zip | 90022-4038
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Country | US
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Telephone | 323-728-8222
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Fax | 323-728-8180
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Provider Business Mailing Address
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Address Line | 5301 WHITTIER BLVD 4TH FLOOR
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City | LOS ANGELES
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State | CA
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Zip | 90022-4038
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Country | US
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Telephone | 323-728-8222
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Fax | 323-728-8180
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | YURY BRICKMAN
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Credential |
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Telephone | 323-728-8222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 209800000X
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Taxonomy Name | Legal Medicine (M.D./D.O.) Physician
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License Number |
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License Number State |
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