Provider Demographics
NPI:1124659784
Name:ORTHOPEDIC AND SURGERY CENTERS OF CALIFORNIA A PROFESSIONAL CORPORATIO
Entity type:Organization
Organization Name:ORTHOPEDIC AND SURGERY CENTERS OF CALIFORNIA A PROFESSIONAL CORPORATIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:KORSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-715-8444
Mailing Address - Street 1:3760 CONVOY ST STE 114
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-3743
Mailing Address - Country:US
Mailing Address - Phone:858-715-8444
Mailing Address - Fax:858-715-8324
Practice Address - Street 1:3760 CONVOY ST STE 114
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-3743
Practice Address - Country:US
Practice Address - Phone:858-715-8444
Practice Address - Fax:858-715-8324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1992760169OtherNPI