Organization
SHORE ORTHOPEDICS A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRETT SHORE MD (OWNER)
(617) 686-7177
Entity
Organization
Contact information
Practice address
4551 GLENCOE AVE STE 145, MARINA DEL REY, CA 90292-6385
(949) 988-7800
Mailing address
2009 FAYMONT AVE, MANHATTAN BEACH, CA 90266-4150
(617) 686-7177
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
12/22/2023
Last updated
03/19/2024
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