Provider Demographics
NPI:1366221350
Name:PRECISION ORTHOPEDICS AND SPORTS MEDICINE
Entity type:Organization
Organization Name:PRECISION ORTHOPEDICS AND SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RCM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:ELENES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-382-0653
Mailing Address - Street 1:1230 S CAMDEN DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1112
Mailing Address - Country:US
Mailing Address - Phone:916-382-0653
Mailing Address - Fax:916-314-9619
Practice Address - Street 1:15525 POMERADO RD STE E6
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2427
Practice Address - Country:US
Practice Address - Phone:877-806-7846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty