Cormorant Orthopaedic Medical Assoc Inc

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

C26647 Issued in CA

Legal business name

CORMORANT ORTHOPAEDIC MEDICAL ASSOC INC

Doing business as

Cormorant Ortho Med Assoc Inc

Practice address

630 S Glassell Street
Ste 201
Orange, CA 92866-3090

Phone

(714) 771-5058

Fax

(714) 639-2778

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Neil D Kravetz, MD

Title

President

Phone

(714) 771-5058

Specialties & licenses 1

Addresses

Other names 1

• Cormorant Ortho Med Assoc Inc Doing business as

Locations

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306060587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S GLASSELL ST",
            "address_2": "STE 201",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928663090",
            "telephone_number": "714-771-5058",
            "fax_number": "714-639-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S GLASSELL STREET",
            "address_2": "STE 201",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928663090",
            "telephone_number": "714-771-5058",
            "fax_number": "714-639-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORMORANT ORTHOPAEDIC MEDICAL ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRAVETZ",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-771-5058",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "C26647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cormorant Ortho Med Assoc Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Evelyn Coria Mondragon, PHARMD
• Kimberly Ashley Coria
• Yessenia Coria
• Corinne Raskind Psychotherapy PC
• Robert Cormier
• Jessica Cornea, LMFT #138932
• Dave Amiel A Cornejo
• Diana Cornejo
• Trisha Therese Billones Cornejo
• Cornelia Seiffert, LCSW, a Licensed Clinical Social Worker Corporation

• Orthopaedic Surgery Physician in Orange, CA
• Providers in Orange, 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 Aug 22, 2020; 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.