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Organization

PROFESSIONAL ORTHOPEDICS MEDICAL ASSOCIATES A PROF MEDICAL CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FREDERICK J LI (FRONT OFFICE SUPERVISOR)
(818) 888-2855
Entity
Organization

Contact information

Practice address
7345 MEDICAL CENTER DR, SUITE #280, WEST HILLS, CA 91307-1937
(818) 888-2855
(818) 888-0702
Mailing address
7345 MEDICAL CENTER DR, SUITE #280, WEST HILLS, CA 91307-1937
(818) 888-2855
(818) 888-0702

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
A79561
CA
207X00000X
Orthopaedic Surgery Physician
Primary
G065065
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E3859
CA
225100000X
Physical Therapist
PT24912
CA
363A00000X
Physician Assistant
PA 16970
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ZZZ53604Z22
BS GROUP
Enumeration date
07/05/2006
Last updated
05/11/2023
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