Southern California Bone and Joint Clinic Inc

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

A112382 Issued in CA

Legal business name

SOUTHERN CALIFORNIA BONE AND JOINT CLINIC INC

Practice address

16008 Kamana Rd
Suite 100
Apple Valley, CA 92307-1376

Phone

(760) 956-5200

Fax

(760) 669-0793

NPI assigned

May 19, 2010

Last updated

Mar 1, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tzu-Shang Thomas Liu, MD, PHDNPI 1922201318

Title

President

Phone

(760) 956-5200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tzu-Shang Thomas Liu, MD PHD

  • Orthopaedic Surgery Physician
  • Apple Valley, CA
  • NPI 1922201318
  Medicare reassignment Care Compare group Authorized official
• Mack Green, MD

  • Sports Medicine (Family Medicine) Physician
  • Apple Valley, CA
  • NPI 1043531676
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1457670226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12277 APPLE VALLEY RD",
            "address_2": "#288",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923081701",
            "telephone_number": "760-956-5200",
            "fax_number": "760-669-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16008 KAMANA RD",
            "address_2": "SUITE 100",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923071376",
            "telephone_number": "760-956-5200",
            "fax_number": "760-669-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA BONE AND JOINT CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-19",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "TZU-SHANG",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-956-5200",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A112382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberto Angel Soto Telles
• Jessica Soto
• Joana Guadalupe Soto
• Amber Sotro
• Soul Journey Family Counseling Org
• Southern California Primary Medical Inc
• Southwest Professional Medical Arts
• Marie Sovitsky
• Maria Soza
• Beverlee Lynn Spencer

• Orthopaedic Surgery Physician in Apple Valley, CA
• Providers in Apple Valley, 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 Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.