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SPINE AND SPORTS SPECIALITIES MEDICAL GROUP NPI 1013306174


NPI Information

NPI: 1013306174
Provider Name: SPINE AND SPORTS SPECIALITIES MEDICAL GROUP
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization

CLIA Number: 05D2106291

Address:
1120 W. LA VETA AVENUE
SUITE 300
ORANGE, CA
ZIP 92868
Phone: (714) 598-1745
Get Directions

SPINE AND SPORTS SPECIALITIES MEDICAL GROUP is an orthopaedic surgery in Orange, CA. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. SPINE AND SPORTS SPECIALITIES MEDICAL GROUP NPI is 1013306174. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1120 W. LA VETA AVENUE
SUITE 300
ORANGE, CA
ZIP 92868-233
Phone: (714) 598-1745
Fax: (714) 941-9539

The provider's authorized official is Corinne Walker .
The authorized official title is Chief Operating Officer and has the following contact phone number (714) 598-1745.

The CLIA number assigned to this NPI record is 05D2106291 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/13/2015 and was last updated on 4/20/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207LP2900XAnesthesiologyPain MedicineNo
2207X00000XOrthopaedic SurgeryCALIFORNIAYes
3207XS0106XOrthopaedic SurgeryHand SurgeryNo
4207XS0114XOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryNo
5207XS0117XOrthopaedic SurgeryOrthopaedic Surgery of the SpineNo
6207XX0004XOrthopaedic SurgeryFoot and Ankle SurgeryNo
7207XX0005XOrthopaedic SurgerySports MedicineNo
82081P2900XPhysical Medicine & RehabilitationPain MedicineNo
9208VP0014XPain MedicineInterventional Pain MedicineNo
10261QU0200XClinic/CenterUrgent CareNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.