# ORTHOPEDIC AND SPINE INSTITUTE OF SOUTHERN CALIFORNIA, INC.

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

## Provider details

- **NPI number:** 1346785649
- **Authorized official:** ROCCO R CALDERONA MD (PRESIDENT)
- **Authorized official phone:** (805) 484-2783

## Contact information

- **Practice address:** 2486 N PONDEROSA DR, STE D114, CAMARILLO, CA 93010-2376
- **Practice address phone:** (805) 484-2783
- **Practice address fax:** (805) 987-8519
- **Mailing address:** 2486 N PONDEROSA DR, STE D114, CAMARILLO, CA 93010-2376
- **Mailing address phone:** (805) 484-2783
- **Mailing address fax:** (805) 987-8519

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | NULL | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | — | — |

## Other

- **Enumeration date:** 12/23/2016
- **Last updated:** 05/24/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5456757 | AETNA | CA |
| 01 | — | ZZZ00347S | BLUE SHIELD PIN | CA |