SPINE AND SPORTS SPECIALITIES MEDICAL GROUP (NPI# 1013306174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013306174 |
| Entity Type | Organization |
| Organization Name | SPINE AND SPORTS SPECIALITIES MEDICAL GROUP |
| Practice Address |
1120 W. La Veta Avenue Suite 300 Orange CA 92868-4233 |
| Practice Telephone | 7145981745 |
| Practice Fax Number | 7149419539 |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2019-05-08 |
| Authorized Official Name | MS. CORINNE WALKER (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 7145981745 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians | ||
| N | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 207X00000X | Orthopaedic Surgery | CA | Allopathic & Osteopathic Physicians | |
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities |
| Street Address |
1120 W. LA VETA AVENUE SUITE 300 |
| City | ORANGE |
| State | CA |
| Zip Code | 92868-4233 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275536633 | Michael J. Gillman | Orthopaedic Surgery | 1120 W. La Veta Avenue, Suite 300, Orange, CA 92868-4246 | 2005-05-31 |
| 1083240204 | Choc Physicians Network, Inc | Health Maintenance Organization | 1120 W. La Veta Avenue, Suite 450, Orange, CA 92868 | 2020-03-19 |
| 1750770814 | Spine and Sports Urgent Care Center Inc. | Clinic/Center | 1120 W. La Veta Avenue, Suite 300, Orange, CA 92868-4233 | 2015-01-13 |
| 1295124352 | Spine and Sports Imaging LLC | Radiology | 1120 W. La Veta Avenue, Suite 300, Orange, CA 92868-4233 | 2015-01-13 |
| 1043479835 | Andrew Germanovich | Anesthesiology | 1120 W. La Veta Avenue, Suite 300, Orange, CA 92868-4246 | 2008-06-05 |
| 1780747287 | Steve A. Mora | Specialist | 1120 W. La Veta Avenue, Suite 300, Orange, CA 92868-4246 | 2006-12-18 |
| 1215924329 | Gregory D. Carlson | Orthopaedic Surgery | 1120 W. La Veta Avenue, Suite 300, Orange, CA 92868-4246 | 2005-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346859386 | Sadaf Abrishami | Pharmacist | 101 The City Dr S., Orange, CA 92868 | 2020-07-27 |
| 1245869825 | Helena Yijia Hong | Student in an Organized Health Care Education/Training Program | Uci Medical Center, 101 The City Drive, Orange, CA 92868 | 2020-04-06 |
| 1932736527 | Joshua Kristopher Livingston | Student in an Organized Health Care Education/Training Program | 101 The City Dr S, Rte. 128-01, Orange, CA 92868 | 2020-03-24 |
| 1831725894 | Michelle Brown | Student in an Organized Health Care Education/Training Program | 101 The City Dr S. Rte 128-01, Orange, CA 92868 | 2020-03-20 |
| 1093363491 | Kristin Lee | Pharmacist | 132 S. Anita Dr., Orange, CA 92868 | 2019-08-28 |
| 1740834217 | Matthew Brian Mecheal | Dentist | 725 W. La Veta Suite 260, Orange, CA 92868 | 2019-08-01 |
| 1245897990 | Brent Tyler Louie | Student in an Organized Health Care Education/Training Program | 101 The City Drive South Building 3, Route 88, Neuropsychiatric Center Uc Irvine Medical Center, Orange, CA 92868 | 2019-05-28 |
| 1093277972 | Danielle Amato | Student in an Organized Health Care Education/Training Program | Uc Irvine Health 101 The City Drive, City Tower, Ste 40, Orange, CA 92868 | 2019-04-01 |
| 1851852206 | Julia Ting Bu | Student in an Organized Health Care Education/Training Program | Uc Irvine Health, 101 The City Drive, City Tower, Ste 400, Orange, CA 92868 | 2019-03-28 |
| 1326507344 | Harrison Beene Lowder | Student in an Organized Health Care Education/Training Program | 505 S. Main St, Suite 525, Orange, CA 92868 | 2019-03-19 |
| Find all providers in zip 92868 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346536703 | Amirhossein Misaghi | Orthopaedic Surgery | 1310 W Stewart Dr Ste 508, Orange, CA 92868-3856 | 2011-06-23 |
| 1497983761 | Andrew Ray Hsu | Orthopaedic Surgery | 101 The City Dr S Bldg 29a, Orange, CA 92868-3201 | 2009-06-25 |
| 1548494248 | Martin C Nation | Orthopaedic Surgery | 1123 W Struck Ave, Orange, CA 92867-3529 | 2009-05-08 |
| 1578746376 | Stephen L. Hall D.o.,p.a | Orthopaedic Surgery | 610 Strickland Dr Ste 100, Orange, TX 77630-4790 | 2007-12-14 |
| 1306060587 | Cormorant Orthopaedic Medical Assoc Inc | Orthopaedic Surgery | 630 S Glassell Street, Ste 201, Orange, CA 92866-3090 | 2007-04-12 |
| 1619920667 | Navid Ghalambor | Orthopaedic Surgery | 1120 W La Veta Ave Ste 300, Spine and Sports Specialties Medical Group, Orange, CA 92868-4246 | 2006-05-19 |
| 1558364836 | Steven Douglas Ross | Orthopaedic Surgery | 101 The City Dr. South, Pavilion Lll, Orange, CA 92868 | 2005-05-31 |
| 1275536633 | Michael J. Gillman | Orthopaedic Surgery | 1120 W. La Veta Avenue, Suite 300, Orange, CA 92868-4246 | 2005-05-31 |
| 1598329377 | Kevin J. Triggs, M.d., Inc | Orthopaedic Surgery | 1310 W Stewart Dr Ste 410, Orange, CA 92868-3855 | 2019-04-26 |
| 1235793019 | Ayaz A. Biviji, M.d., Inc | Orthopaedic Surgery | 1310 W Stewart Dr Ste 410, Orange, CA 92868-3855 | 2019-04-26 |
| Find all providers in ORANGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.