# TRI-VALLEY ORTHOPEDIC AND SPORTS MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tri-Valley Orthopedic Specialists Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609987254
- **Authorized official:** DEBORAH RHOTON (BILLING DEPARTMENT MANAGER)
- **Authorized official phone:** (925) 469-0939

## Contact information

- **Practice address:** 2180 W GRANT LINE RD, SUITE 100, TRACY, CA 95377-7309
- **Practice address phone:** (209) 833-6821
- **Practice address fax:** (209) 833-3328
- **Mailing address:** 4626 WILLOW RD, SUITE 200, PLEASANTON, CA 94588-2710
- **Mailing address phone:** (925) 469-0939
- **Mailing address fax:** (925) 469-0165

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 11/08/2010