Active NPI
Golden State Bone and Joint Clinic
- Orthopaedic Surgery Physician
- Beverly Hills, CA
National Provider Identifier
1508139957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- A100628
- Legal business name
- GOLDEN STATE BONE AND JOINT CLINIC
- Practice address
- 9033 Wilshire Blvd
Suite 403
Beverly Hills, CA 90210-1847 - Phone
- (310) 858-3800
- Fax
- (888) 589-6241
- NPI assigned
- Feb 15, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Matthew J. Enna, MD
- Title
- Owner
- Phone
- (310) 858-3880
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | A100628 | CA | Primary |
| Orthopaedic Hand Surgery Physician | 207XS0106X | A100628 | CA | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | A100628 | CA |
Addresses
Primary practice location
9033 Wilshire Blvd
Suite 403
Beverly Hills, CA 90210-1847
Mailing address
9033 Wilshire Blvd
Suite 403
Beverly Hills, CA 90210-1847
Phone (310) 858-3800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Beverly Hills, CA
- NPI 1396797809
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Los Angeles, CA
- NPI 1023428414
-
- Orthopaedic Foot and Ankle Surgery Physician
- Reno, NV
- NPI 1730308552
CA, Orthopaedic Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329264000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1369094400000",
"number": "1508139957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9033 WILSHIRE BLVD",
"address_2": "SUITE 403",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902101847",
"telephone_number": "310-858-3800",
"fax_number": "888-589-6241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9033 WILSHIRE BLVD",
"address_2": "SUITE 403",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902101847",
"telephone_number": "310-858-3800",
"fax_number": "888-589-6241"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOLDEN STATE BONE AND JOINT CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2012-02-15",
"last_updated": "2013-05-21",
"status": "A",
"authorized_official_last_name": "ENNA",
"authorized_official_first_name": "MATTHEW",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "310-858-3880",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "A100628",
"primary": true
},
{
"code": "207XS0106X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "CA",
"license": "A100628",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "CA",
"license": "A100628",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.