Organization
ADVANCED ORTHOPEDIC SPECIALISTS MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT M. FAY M.D. (PRESIDENT)
(760) 485-7402
Entity
Organization
Contact information
Practice address
720 N NORMA ST, SUITE A AND B, RIDGECREST, CA 93555-3553
(760) 485-7402
(760) 771-4183
Mailing address
PO BOX 839, LA QUINTA, CA 92247-0839
(760) 485-7402
(760) 771-4183
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
A68720
CA
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
A68720
CA
207X00000X
Orthopaedic Surgery Physician
Primary
A68720
CA
207XS0106X
Orthopaedic Hand Surgery Physician
A68720
CA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
A68720
CA
207XS0117X
Orthopaedic Surgery of the Spine Physician
A68720
CA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
A68720
CA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
A68720
CA
207XX0801X
Orthopaedic Trauma Physician
A68720
CA
208200000X
Plastic Surgery Physician
A68720
CA
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
A68720
CA
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
A68720
CA
2086S0102X
Surgical Critical Care Physician
A68720
CA
2086S0127X
Trauma Surgery Physician
A68720
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A68720
MEDICAL LICENSE
CA
Enumeration date
10/23/2006
Last updated
03/07/2023
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