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General NPI Number Information
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NPI Number | 1841557691
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Entity Type | Organization
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Legal Business Name | SKYLAR ORTHOPEDICS A MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 04/18/2012
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Provider Practice Location Address
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Address Line | 302 W LA VETA AVE SUITE 100
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City | ORANGE
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State | CA
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Zip | 92866-2607
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Country | US
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Telephone | 714-769-8400
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Fax | 714-769-8381
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Provider Business Mailing Address
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Address Line | 302 W LA VETA AVE SUITE 100
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City | ORANGE
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State | CA
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Zip | 92866-2607
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Country | US
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Telephone | 714-769-8400
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Fax | 714-769-8381
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Authorized Official
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Title or Position | MANAGEMENT
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Name | MRS. PENNIE LEANN TELARROJA
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Credential |
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Telephone | 909-447-4787
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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 | G083591
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License Number State | CA
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