Organization
HAVEN ORTHOPEDICS & SPINE INSTITUTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FADY ELIAS MD (MD)
(909) 372-0000
Entity
Organization
Contact information
Practice address
10390 COMMERCE CENTER DR STE C100, RANCHO CUCAMONGA, CA 91730-5858
(909) 372-0000
Mailing address
10390 COMMERCE CENTER DR STE C100, RANCHO CUCAMONGA, CA 91730-5858
(909) 372-0000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
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