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Organization
PROFESSIONAL ORTHOPEDICS MEDICAL ASSOCIATES A PROF MEDICAL CORP
Active
Organization
PROFESSIONAL ORTHOPEDICS MEDICAL ASSOCIATES A PROF MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK J LI (FRONT OFFICE SUPERVISOR)
(818) 888-2855
Entity
Organization
Contact information
Practice address
7345 MEDICAL CENTER DR, SUITE #280, WEST HILLS, CA 91307-1937
(818) 888-2855
(818) 888-0702
Mailing address
7345 MEDICAL CENTER DR, SUITE #280, WEST HILLS, CA 91307-1937
(818) 888-2855
(818) 888-0702
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
A79561
CA
207X00000X
Orthopaedic Surgery Physician
Primary
G065065
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E3859
CA
225100000X
Physical Therapist
PT24912
CA
363A00000X
Physician Assistant
PA 16970
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ53604Z22
BS GROUP
—
Enumeration date
07/05/2006
Last updated
05/11/2023
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