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General NPI Number Information
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NPI Number | 1811045313
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Entity Type | Organization
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Legal Business Name | ORTHONORCAL, INC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 05/15/2013
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Provider Practice Location Address
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Address Line | 3803 S BASCOM AVE STE 102
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City | CAMPBELL
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State | CA
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Zip | 95008-7317
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Country | US
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Telephone | 408-412-8100
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Fax | 408-369-9035
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Provider Business Mailing Address
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Address Line | 3803 S BASCOM AVE STE 102
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City | CAMPBELL
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State | CA
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Zip | 95008-7317
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Country | US
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Telephone | 408-412-8100
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Fax | 408-369-9035
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Authorized Official
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Title or Position | PHYSICIANS-PRESIDENT
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Name | MR. NATHANIEL P COHEN
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Credential | M.D.
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Telephone | 408-412-8100
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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 | 770428611
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License Number State | CA
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