# ORTHOPAEDIC QUALIFIED MEDICAL EVALUATORS

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

## Provider details

- **NPI number:** 1760109037
- **Authorized official:** ALEXANDRIA HENRY (EXECUTIVE ASSISTANT)
- **Authorized official phone:** (213) 947-0000

## Contact information

- **Practice address:** 13160 MINDANAO WAY STE 310, MARINA DEL REY, CA 90292-7907
- **Practice address phone:** (213) 947-0000
- **Mailing address:** 13160 MINDANAO WAY STE 310, MARINA DEL REY, CA 90292-7907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 10/26/2022
- **Last updated:** 10/26/2022