Ortho Shock Wave Therapy, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

ORTHO SHOCK WAVE THERAPY, INC.

Practice address

3636 Harbor Blvd
H2
Costa Mesa, CA 92626

Phone

(714) 966-9335

Fax

(714) 966-9706

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Dale Willetts

Title

Chief Executive Officer

Phone

(714) 966-9335

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356430482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3303 HARBOR BLVD",
            "address_2": "SUITE H2",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261530",
            "telephone_number": "714-966-9335",
            "fax_number": "714-966-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 HARBOR BLVD",
            "address_2": "H2",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "92626",
            "telephone_number": "714-966-9335",
            "fax_number": "714-966-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO SHOCK WAVE THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLETTS",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "714-966-9335",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzana Diane Orozco
• Marni Leigh Orsbern, PSY.D.
• Constance Elizabeth Ortega, PSYD
• Jorge Antonio Ortega
• Karina Lizbeth Ortega
• Orthopedic and Sports Medicine Center
• Orthopedic Pain & Spine Center PC
• Alison Joana Ortiz Andrade
• Sharool Rut Ortiz Aragon
• Danielle Ortiz

• Specialist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Specialist 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.