MEDICARE: EAST LOS ANGELES CENTER FOR ORTHOPEDICS AND REHABILITATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	209800000X	Legal Medicine (M.D./D.O.) Physician

General Provider Information

NPI Number	:	1093029662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST LOS ANGELES CENTER FOR ORTHOPEDICS AND REHABILITATION

Provider Business Mailing Address
First Line	:	5301 WHITTIER BLVD
Second Line	:	STE 400
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-4038
Country	:	US
Telephone Number	:	323-728-8222
Fax Number	:

Provider Business Practice Location Address
First Line	:	5301 WHITTIER BLVD
Second Line	:	STE 400
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-4038
Country	:	US
Telephone Number	:	323-728-8222
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	LANA GEYBER
Credential	:	MD
Telephone Number	:	323-728-8222

Provider Enumeration Date	:	08/05/2010
Last Update Date	:	08/05/2010

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