BACK TO WORK ORTHOPEDIC MEDICAL GROUP (NPI# 1417226804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417226804 |
| Entity Type | Organization |
| Organization Name | BACK TO WORK ORTHOPEDIC MEDICAL GROUP |
| Practice Address |
5203 Lakewood Blvd Lakewood CA 90712-2438 |
| Practice Telephone | 5626332273 |
| Mailing Telephone | 5626332273 |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2011-12-14 |
| Authorized Official Name | KEVIN PARK (MD) |
| Authorized Official Telephone | 5626332273 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | Managed Care Organizations |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376076620 | Back To Work Orthopedic Medical Group | Preferred Provider Organization | 7300 Alondra Blvd, Ste 100, Paramount, CA 90723-4000 | 2017-04-04 |
| 1619246980 | Back To Work Orthopedic Medical Group | Preferred Provider Organization | 6538 Telegraph Rd, Commerce, CA 90040-2518 | 2011-12-15 |
| 1306115795 | Back To Work Orthopedic Medical Group | Preferred Provider Organization | 15330 Valley View Ave Ste 1, La Mirada, CA 90638-5238 | 2011-12-14 |
| 1700155199 | Back To Work Orthopedic Medical Group | Preferred Provider Organization | 7300 Alondra Blvd Ste 101, Paramount, CA 90723-4000 | 2011-12-14 |
| Street Address |
5203 LAKEWOOD BLVD |
| City | LAKEWOOD |
| State | CA |
| Zip Code | 90712-2438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063578110 | Craig John Carbonniere Sr. | Physician Assistant | 5203 Lakewood Blvd, Lakewood, CA 90712-2438 | 2006-12-30 |
| 1558926428 | Florabel Reynoso | Physical Therapy Assistant | 5203 Lakewood Blvd, Suite B, Lakewood, CA 90712 | 2019-05-07 |
| 1548507239 | Ehab Samaan Dds,inc | Dentist | 5203 Lakewood Blvd, Lakewood, CA 90712-2438 | 2013-01-15 |
| 1629312947 | Dr.samaan Dental Group | Dentist | 5203 Lakewood Blvd, Lakewood, CA 90712-2438 | 2012-11-27 |
| 1215140629 | Kimberley Ludlow | Specialist | 5203 Lakewood Blvd, Lakewood, CA 90712-2415 | 2007-05-08 |
| 1811042351 | Southern California Immediate Medical Center | Family Medicine | 5203 Lakewood Blvd, Lakewood, CA 90712-2415 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689289944 | Createwellness LLC | Social Worker | 5250 Hayter Avenue, Lakewood, CA 90712 | 2020-09-14 |
| 1801451398 | Marilou Toquero Dental Corp | Durable Medical Equipment & Medical Supplies | 3203 Carson St Suite 2, Lakewood, CA 90712 | 2019-05-09 |
| 1225510126 | N Ozder Dental Practice Inc | Clinic/Center | 5037 Lakewood Blvd, Lakewood, CA 90712 | 2018-09-06 |
| 1003394446 | Robert Michael Schlesinger | Counselor | 5150 Candlewood St Ste 13a, Lakewood, CA 90712 | 2018-07-28 |
| 1316439847 | P.r.i.s.m. Institute Inc. | Chiropractor | 5233 Premiere Ave, Lakewood, CA 90712 | 2018-05-31 |
| 1316477938 | Broadleaf Healthcare | Orthotist | 4345 Levelside Ave, Lakewood, CA 90712 | 2017-06-15 |
| 1679008049 | Adrienne Yoshiko Doi | Podiatrist | 3700 East South Street, Lakewood, CA 90712 | 2017-04-24 |
| 1841747334 | Garrison R Weaver-gourdeau | Chiropractor | 4115 E. South St, Lakewood, CA 90712 | 2016-09-01 |
| 1073967394 | Mirna S Rizkalla | Family Medicine | 3650 South St Ste 404, Lakewood, CA 90712 | 2016-04-22 |
| 1841657251 | Roxanna Jimenez | Rehabilitation Practitioner | 5818 Clark Ave, Lakewood, CA 90712 | 2016-01-15 |
| Find all providers in zip 90712 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932305299 | Rdcs, LLC | Preferred Provider Organization | 1360 S. Wadsworth Blvd. #106, Lakewood, CO 80232 | 2007-06-25 |
| 1518979434 | Mountainside Psychiatric Services | Preferred Provider Organization | 10209 Bridgeport Way Sw, Suite D 10, Lakewood, WA 98499-2320 | 2006-08-12 |
| 1831575547 | S.i. Talavera,llc | Preferred Provider Organization | 1692 Wadsworth Blvd Unit 105, Lakewood, CO 80214-5233 | 2015-08-04 |
| 1790057206 | Premier Aco Physicians Network, Inc | Preferred Provider Organization | 4909 Lakewood Blvd, Suite 200, Lakewood, CA 90712 | 2012-01-30 |
| 1023214384 | Hector Villalobos | Preferred Provider Organization | 1360 S. Wadsworth Blvd. #106, Lakewood, CO 80232 | 2007-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154961142 | Hoag Physcian Partners | Preferred Provider Organization | 16148 Sand Canyon Ave Fl 2, Irvine, CA 92618-3700 | 2020-01-08 |
| 1356806525 | Premierone Plus Aco | Preferred Provider Organization | 1210 N Jefferson St Ste D, Anaheim, CA 92807-1630 | 2019-02-01 |
| 1548730450 | Mastour & Fard Dental Corp | Preferred Provider Organization | 587 N. Ventu Park Road., Suite C, Newberry Park, CA 91320 | 2018-12-04 |
| 1689151698 | David W Schwartz Md A Medical Corporation | Preferred Provider Organization | 29645 Rancho California Rd Ste 105, Temecula, CA 92591 | 2018-07-23 |
| 1184100471 | Care Allies Ipa, Inc | Preferred Provider Organization | 1211 W La Palma Ave Ste 309, Anaheim, CA 92801-2811 | 2018-07-19 |
| 1245723071 | Pacific Associates Medical Group, Inc. | Preferred Provider Organization | 9900 Lakewood Blvd Ste 103, Downey, CA 90240-4039 | 2018-06-06 |
| 1821585266 | Anthony Nguyen Dds Inc | Preferred Provider Organization | 1125 E 17th St Ste N156, Santa Ana, CA 92701-2215 | 2018-04-20 |
| 1275038051 | Ryan Lange D.m.d. Inc. | Preferred Provider Organization | 17897 Macarthur Blvd Ste 100, Irvine, CA 92614-0532 | 2018-03-26 |
| 1649798190 | Freedom Physicians Corporation | Preferred Provider Organization | 2295 Huntington Dr., Ste. D, San Marino, CA 91108 | 2017-09-05 |
| 1952835282 | Dr. Jose Flores D.d.s Inc. | Preferred Provider Organization | 11510 Downey Ave, Downey, CA 90241 | 2017-04-13 |
| Find all providers with the same taxonomy | ||||
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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.