# CHICO ORTHOPAEDIC SURGERY AND SPORTS MEDICAL ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023325347
- **Authorized official:** MS. DYANNA R JOHNSON (PRACTICE MANAGER)
- **Authorized official phone:** (530) 891-6375

## Contact information

- **Practice address:** 111 RALEY BLVD, SUITE 160, CHICO, CA 95928-8351
- **Practice address phone:** (530) 891-6375
- **Practice address fax:** (530) 891-6952
- **Mailing address:** 111 RALEY BLVD, SUITE 160, CHICO, CA 95928-8351
- **Mailing address phone:** (530) 891-6375
- **Mailing address fax:** (530) 891-6952

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | G52675 | CA | — |
| 207X00000X | Orthopaedic Surgery Physician | G86463 | CA | Yes |

## Other

- **Enumeration date:** 09/08/2010
- **Last updated:** 09/08/2010