Advanced Orthopedic Center Inc
Organization Active NPI Orthopaedic Surgery Physician · Poway, CA
NPI 1992902860 · NPPES record last updated Sep 27, 2023
Key facts
- NPI
- 1992902860
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- ADVANCED ORTHOPEDIC CENTER INC
- Practice address
- 15525 Pomerado Road
Suite E-6
Poway, CA 92064-2427 - Phone
- (858) 451-2280
- Fax
- (858) 451-2006
- NPI assigned
- Jul 2, 2007
- Organization subpart
- No
Authorized official
- Name
- Jonathan Nissanoff, MD
- Title
- Ceo
- Phone
- (858) 451-2280
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100511000692 | CA | Part B Supplier - Clinic/Group Practice | 1951439041 |
Receives reassigned benefits from 1 practitioner Practice locations: Century City, CA |
National Provider Directory
Locations
15525 Pomerado Rd
Poway, CA 92064
Phone (858) 485-6600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | G82348 | CA | |
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
15525 Pomerado Road
Suite E-6
Poway, CA 92064-2427
Mailing address
1230 S Camden Dr
Los Angeles, CA 90035-1112
Phone (858) 451-2280
Other providers in Poway, CA
- Acupuncture Center, Inc.
- Acupuncture for Mind & Body, Inc
- Haley Adams
- Sharon E Adler
- Loubaba Adlouni
- Advanced Psychiatric Wellness, a Nursing Corporation
- Advanced Radiology Conultants, a Medical Corporation
- Deborah Agad
- Sabrena Agoubi
- Shelby L Agreste
All providers in Poway, CA · Orthopaedic Surgery Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.