Organization
OPTIMAL PHYSICIAN SURGICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEILESH CHODADRA M.D. (CEO)
(678) 596-1344
Entity
Organization
Contact information
Practice address
25067 JIM BRIDGER RD, HIDDEN HILLS, CA 91302-1128
(678) 596-1344
(310) 453-2535
Mailing address
25067 JIM BRIDGER RD, HIDDEN HILLS, CA 91302-1128
(678) 596-1344
(310) 453-2535
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
A116169
CA
Other
Enumeration date
11/06/2017
Last updated
11/06/2017
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