NPIMap

Organization Active NPI

Long Beach - Lakewood Orthopedic Institute

  • Multi-Specialty Clinic/Center
  • Lakewood, CA
National Provider Identifier
1710020755
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
LONG BEACH - LAKEWOOD ORTHOPEDIC INSTITUTE
Practice address
5750 Downey Ave Ste 308
Lakewood, CA 90712
Phone
(562) 633-3787
Fax
(562) 633-1977
NPI assigned
Feb 15, 2007
Last updated
Aug 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Dr. Ezzat Wadih WassefNPI 1427063197
Title
General Partner
Phone
(562) 633-3787

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Multi-Specialty Clinic/Center 261QM1300X Primary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X

Addresses

Primary practice location

5750 Downey Ave Ste 308
Lakewood, CA 90712

Mailing address

PO Box 15848
Newport Beach, CA 92659-5848
Phone (657) 241-3600

Other practice location 1

3610 Long Beach Blvd Ste 202
Long Beach, CA 90807
Phone (562) 427-8119

Other identifiers 1

IdentifierTypeStateIssuer
GR0066890MedicaidCA

Other names 1

  • Lakewood Orthopaedic Surgical & Medical Group Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040331001691 CA Part B Supplier - Clinic/Group Practice 0840282786 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
Practice locations: Lakewood, CA; Long Beach, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

5750 Downey Ave
Ste 308
Lakewood, CA 90712
Phone (562) 633-3757

3610 Long Beach Blvd
Ste 202
Long Beach, CA 90807
Phone (562) 427-8119

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1710020755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15848",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926595848",
            "telephone_number": "657-241-3600",
            "fax_number": "657-241-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 DOWNEY AVE STE 308",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "90712",
            "telephone_number": "562-633-3787",
            "fax_number": "562-633-1977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3610 Long Beach Blvd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "90807",
            "country_code": "US",
            "telephone_number": "562-427-8119",
            "fax_number": "562-546-1227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LONG BEACH - LAKEWOOD ORTHOPEDIC INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "WASSEF",
        "authorized_official_first_name": "EZZAT",
        "authorized_official_middle_name": "WADIH",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "562-633-3787",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0066890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakewood Orthopaedic Surgical & Medical Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.