Organization
SEVENTEENTH STREET ORTHOPEDIC SPECIALTY MEDICAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHYLLIS R BROURMAN ESQ (ATTORNEY)
(310) 657-2202
Entity
Organization
Contact information
Practice address
1450 E 17TH ST, # 100, SANTA ANA, CA 92705-8510
(714) 565-1000
(714) 565-1974
Mailing address
1450 E 17TH ST, # 100, SANTA ANA, CA 92705-8510
(714) 565-1000
(714) 565-1974
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
11/28/2006
Last updated
08/22/2020
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