Provider Demographics
NPI:1730571514
Name:REGENERATIVE ORTHOPEDICS
Entity type:Organization
Organization Name:REGENERATIVE ORTHOPEDICS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KHYBER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAFFARKHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-438-1888
Mailing Address - Street 1:1601 DOVE ST STE 275
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2433
Mailing Address - Country:US
Mailing Address - Phone:949-438-1888
Mailing Address - Fax:
Practice Address - Street 1:1601 DOVE ST
Practice Address - Street 2:STE 275
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2433
Practice Address - Country:US
Practice Address - Phone:949-438-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9973261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain