Basic Information
Provider Information | |||||||||
NPI: | 1942454442 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | ORTHOPEDIC HOSPITALISTS OF OXNARD PC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 79687 | ||||||||
Address2: |   | ||||||||
City: | CITY OF INDUSTRY | ||||||||
State: | CA | ||||||||
PostalCode: | 917169687 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3304703700 | ||||||||
FaxNumber: | 3304977940 | ||||||||
Practice Location | |||||||||
Address1: | 1700 N ROSE AVE | ||||||||
Address2: |   | ||||||||
City: | OXNARD | ||||||||
State: | CA | ||||||||
PostalCode: | 930303790 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8059887077 | ||||||||
FaxNumber: | 8059888992 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/11/2008 | ||||||||
LastUpdateDate: | 04/15/2011 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | REID | ||||||||
AuthorizedOfficialFirstName: | E. | ||||||||
AuthorizedOfficialMiddleName: | PAUL | ||||||||
AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
AuthorizedOfficialTelephone: | 8668855522 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | MD | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X |   |   | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |   |
No ID Information.