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Organization
KERLAN-JOBE ORTHOPAEDIC CLINIC
Active
Organization
KERLAN-JOBE ORTHOPAEDIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RALPH A GAMBARDELLA M.D. (PRESIDENT)
(310) 665-7235
Entity
Organization
Contact information
Practice address
6801 PARK TER, SUITE 500, LOS ANGELES, CA 90045-1543
(310) 665-7235
Mailing address
6801 PARK TER, SUITE 500, LOS ANGELES, CA 90045-1543
(310) 665-7235
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
NULL
208VP0000X
Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ56985Z
BLUE SHIELD OF CA
CA
01
—
ZZZ56988Z
BLUE SHIELD OF CA
CA
05
—
ZZZ788127
—
CA
01
—
ZZZ98667Z
BLUE SHIELD OF CA
CA
Enumeration date
02/07/2006
Last updated
03/05/2012
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