# HAVEN ORTHOPEDICS & SPINE INSTITUTE INC

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

## Provider details

- **NPI number:** 1215404132
- **Authorized official:** FADY ELIAS MD (MD)
- **Authorized official phone:** (909) 372-0000

## Contact information

- **Practice address:** 10390 COMMERCE CENTER DR STE C100, RANCHO CUCAMONGA, CA 91730-5858
- **Practice address phone:** (909) 372-0000
- **Mailing address:** 10390 COMMERCE CENTER DR STE C100, RANCHO CUCAMONGA, CA 91730-5858
- **Mailing address phone:** (909) 372-0000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 10/29/2018
- **Last updated:** 10/29/2018