# GOLDEN STATE BONE AND JOINT CLINIC

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

## Provider details

- **NPI number:** 1508139957
- **Authorized official:** MATTHEW J. ENNA MD (OWNER)
- **Authorized official phone:** (310) 858-3880

## Contact information

- **Practice address:** 9033 WILSHIRE BLVD, SUITE 403, BEVERLY HILLS, CA 90210-1847
- **Practice address phone:** (310) 858-3800
- **Practice address fax:** (888) 589-6241
- **Mailing address:** 9033 WILSHIRE BLVD, SUITE 403, BEVERLY HILLS, CA 90210-1847
- **Mailing address phone:** (310) 858-3800
- **Mailing address fax:** (888) 589-6241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | A100628 | CA | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | A100628 | CA | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | A100628 | CA | — |

## Other

- **Enumeration date:** 02/15/2012
- **Last updated:** 05/21/2013