# ST JOHN BOSCO HIGH SCHOOL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SJB Sports Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154920684
- **Authorized official:** MELODY MOHEBBI (ADMISTRATOR)
- **Authorized official phone:** (562) 920-1734

## Contact information

- **Practice address:** 13640 BELLFLOWER BLVD, BELLFLOWER, CA 90706-2408
- **Practice address phone:** (562) 920-1734
- **Mailing address:** 5050 SPRING VALLEY RD, DALLAS, TX 75244-3995

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/26/2020
- **Last updated:** 10/26/2020