Organization
CHICO ORTHOPAEDIC SURGERY AND SPORTS MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DYANNA R JOHNSON (PRACTICE MANAGER)
(530) 891-6375
Entity
Organization
Contact information
Practice address
111 RALEY BLVD, SUITE 160, CHICO, CA 95928-8351
(530) 891-6375
(530) 891-6952
Mailing address
111 RALEY BLVD, SUITE 160, CHICO, CA 95928-8351
(530) 891-6375
(530) 891-6952
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
G52675
CA
207X00000X
Orthopaedic Surgery Physician
Primary
G86463
CA
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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