Raven Orthopaedics, Inc.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

A66365 Issued in CA

Legal business name

RAVEN ORTHOPAEDICS, INC.

Practice address

3413 W Pacific Ave Ste 100
Burbank, CA 91505-1598

Phone

(818) 841-3936

Fax

(818) 841-5974

NPI assigned

Aug 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Raymond B. Raven III, M.D.

Title

President

Phone

(818) 841-3936

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1043404387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3413 W PACIFIC AVE STE 100",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915051598",
            "telephone_number": "818-841-3936",
            "fax_number": "818-841-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3413 W PACIFIC AVE STE 100",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915051598",
            "telephone_number": "818-841-3936",
            "fax_number": "818-841-5974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27372 Aliso Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Aliso Viejo",
            "state": "CA",
            "postal_code": "926565339",
            "country_code": "US",
            "telephone_number": "949-520-1012",
            "fax_number": "949-520-1045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RAVEN ORTHOPAEDICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "RAVEN",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-841-3936",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A66365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A663650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Burbank, CA
• Providers in Burbank, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.