Organization
MARINA ORTHO, INC.
Active
Other names
DIAGNOSTIC AND INTERVENTIONAL SPINE CARE, A MEDICAL CORPORATION
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN MARIE KENNEDY (PRACTICE ADMINISTRATOR)
(310) 574-0367
Entity
Organization
Contact information
Practice address
13160 MINDANAO WAY STE 300, MARINA DEL REY, CA 90292-6393
(310) 574-0367
Mailing address
13160 MINDANAO WAY STE 300, MARINA DEL REY, CA 90292-6393
(310) 574-0367
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/08/2017
Last updated
10/28/2017
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