# CORMORANT ORTHOPAEDIC MEDICAL ASSOC INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cormorant Ortho Med Assoc Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306060587
- **Authorized official:** NEIL D KRAVETZ MD (PRESIDENT)
- **Authorized official phone:** (714) 771-5058

## Contact information

- **Practice address:** 630 S GLASSELL STREET, STE 201, ORANGE, CA 92866-3090
- **Practice address phone:** (714) 771-5058
- **Practice address fax:** (714) 639-2778
- **Mailing address:** 630 S GLASSELL ST, STE 201, ORANGE, CA 92866-3090
- **Mailing address phone:** (714) 771-5058
- **Mailing address fax:** (714) 639-2778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | C26647 | CA | Yes |

## Other

- **Enumeration date:** 04/12/2007
- **Last updated:** 08/22/2020