# STEVENSON ORTHOPAEDIC MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1376638965
- **Authorized official:** DR. DONALD V STEVENSON M.D. (PRESIDENT)
- **Authorized official phone:** (310) 674-1211

## Contact information

- **Practice address:** 575 E HARDY ST, SUITE 105, INGLEWOOD, CA 90301-4040
- **Practice address phone:** (310) 674-1211
- **Practice address fax:** (310) 674-8668
- **Mailing address:** 575 E HARDY ST, SUITE 105, INGLEWOOD, CA 90301-4040
- **Mailing address phone:** (310) 674-1211
- **Mailing address fax:** (310) 674-8668

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | G48296 | CA | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 04/05/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00G482960 | — | CA |