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Organization
ORTHOPEDIC CONSULTANTS MEDICAL GROUP, INC.
Active
Organization
ORTHOPEDIC CONSULTANTS MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK WELLISCH M.D. (MANAGING PARTNER)
(818) 788-7343
Entity
Organization
Contact information
Practice address
16311 VENTURA BLVD, SUITE 800, ENCINO, CA 91436-2124
(818) 788-7343
(818) 788-9453
Mailing address
16311 VENTURA BLVD, SUITE 800, ENCINO, CA 91436-2124
(818) 788-7343
(818) 788-9453
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ77447Z
—
CA
Enumeration date
12/18/2006
Last updated
08/22/2020
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