MEDICARE: ADVANCED SPINE CARE

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	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1326808643
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED SPINE CARE

Provider Business Mailing Address
First Line	:	4281 KATELLA AVE STE 120
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3592
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4281 KATELLA AVE STE 120
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3592
Country	:	US
Telephone Number	:	562-732-4578
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KUSHAGRA VERMA
Credential	:
Telephone Number	:	562-732-4578

Provider Enumeration Date	:	03/21/2024
Last Update Date	:	03/21/2024

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Directions to “ADVANCED SPINE CARE ” Practice Location

Language	Start Address	Practice Location

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