Organization
TORRANCE ORTHOPAEDIC AND SPORTS MEDICINE GROUP
Active
Other names
CoastalOrtho
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA A AMEZOLA (BILLING MANAGER)
(310) 316-6190
Entity
Organization
Contact information
Practice address
5215 TORRANCE BLVD STE 210, TORRANCE, CA 90503-4009
(310) 316-6190
(310) 540-7362
Mailing address
5215 TORRANCE BLVD STE 210, TORRANCE, CA 90503-4009
(310) 316-6190
(310) 540-7362
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
22653
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22653
FICTICIOUS NAME PERMIT
CA
Enumeration date
06/03/2006
Last updated
07/23/2020
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