Organization
SPINE AND SPORTS SPECIALITIES MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CORINNE WALKER (CHIEF OPERATING OFFICER)
(714) 598-1745
Entity
Organization
Contact information
Practice address
1120 W. LA VETA AVENUE, SUITE 300, ORANGE, CA 92868-4233
(714) 598-1745
(714) 941-9539
Mailing address
1120 W LA VETA AVE STE 300, ORANGE, CA 92868-4246
(714) 598-1745
(714) 941-9539
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
CA
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
261QR0200X
Radiology Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
01/13/2015
Last updated
11/01/2024
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