# 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:** 1801883731
- **Authorized official:** DEBORAH RHOTON (BILLING DEPARTMENT MANAGER)
- **Authorized official phone:** (925) 469-0939

## Contact information

- **Practice address:** 5601 NORRIS CANYON RD, SUITE 130, SAN RAMON, CA 94583-5407
- **Practice address phone:** (925) 275-1133
- **Practice address fax:** (925) 275-1298
- **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 | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |

## Other

- **Enumeration date:** 10/05/2005
- **Last updated:** 02/27/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CP2106 | MEDICARE RAILROAD | CA |