Mission Orthopedics Surgery and Sports Medicine

Key facts

NPI

1770699282

Entity type

Organization (NPI type 2)

Primary specialty

Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X

Legal business name

MISSION ORTHOPEDICS SURGERY AND SPORTS MEDICINE

Practice address

1201 E Ocean Ave
Suite B
Lompoc, CA 93436-7081

Phone

(805) 963-3336

Fax

(805) 564-3332

NPI assigned

Aug 21, 2006

Organization subpart

No

Authorized official

Name

Dr. Colvin Clay Wellborn, MD NPI 1760478259

Title

President

Phone

(805) 963-3336

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Colvin Clay Wellborn, M.D. Orthopaedic Surgery Physician · Arlington, VA · NPI 1760478259
  NPD (past) Authorized official ORTHOPAEDIC SURGERY

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770699282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50706",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931500706",
            "telephone_number": "805-963-3336",
            "fax_number": "805-564-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E OCEAN AVE",
            "address_2": "SUITE B",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934367081",
            "telephone_number": "805-963-3336",
            "fax_number": "805-564-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION ORTHOPEDICS SURGERY AND SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WELLBORN",
        "authorized_official_first_name": "COLVIN",
        "authorized_official_middle_name": "CLAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-963-3336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G846660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lompoc, CA

• Edward M. Mikowicz, D.D.S.
• Angela Frances Milholland
• Rosemarie Miller, LAADC
• Oboli Minasse, PHAMD
• Alexia Yaire Miranda
• Damani Muata Mitchell, DDS
• James Edward Mitchell
• Jeremy Mitchell
• Shereen Mizany, OTR / L, MOT
• Haley Mogensen

All providers in Lompoc, CA · Sports Medicine (Orthopaedic Surgery) Physician in California