Organization
ORTHOPEDIC AND SPINE INSTITUTE OF SOUTHERN CALIFORNIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROCCO R CALDERONA MD (PRESIDENT)
(805) 484-2783
Entity
Organization
Contact information
Practice address
2486 N PONDEROSA DR, STE D114, CAMARILLO, CA 93010-2376
(805) 484-2783
(805) 987-8519
Mailing address
2486 N PONDEROSA DR, STE D114, CAMARILLO, CA 93010-2376
(805) 484-2783
(805) 987-8519
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5456757
AETNA
CA
01
—
ZZZ00347S
BLUE SHIELD PIN
CA
Enumeration date
12/23/2016
Last updated
05/24/2017
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