Organization
GOLDEN STATE BONE AND JOINT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW J. ENNA MD (OWNER)
(310) 858-3880
Entity
Organization
Contact information
Practice address
9033 WILSHIRE BLVD, SUITE 403, BEVERLY HILLS, CA 90210-1847
(310) 858-3800
(888) 589-6241
Mailing address
9033 WILSHIRE BLVD, SUITE 403, BEVERLY HILLS, CA 90210-1847
(310) 858-3800
(888) 589-6241
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A100628
CA
207XS0106X
Orthopaedic Hand Surgery Physician
A100628
CA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
A100628
CA
Other
Enumeration date
02/15/2012
Last updated
05/21/2013
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