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General NPI Number Information
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NPI Number | 1992999387
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Entity Type | Organization
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Legal Business Name | OA MEDICAL GROUP INC
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 11/17/2010
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Provider Practice Location Address
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Address Line | 1950 SAWTELLE BLVD SUITE 150
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City | W LOS ANGELES
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State | CA
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Zip | 90025
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Country | US
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Telephone | 310-996-8500
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Fax | 310-445-8746
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Provider Business Mailing Address
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Address Line | 1950 SAWTELLE BLVD SUITE 150
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City | W LOS ANGELES
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State | CA
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Zip | 90025
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Country | US
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Telephone | 310-996-8500
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Fax | 310-445-8746
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD P POLLIS
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Credential | MD
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Telephone | 310-996-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | G29563
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G29563
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License Number State | CA
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