OrganizationActive
Back to Work Orthopedic Medical Group
NPI 1306115795 · Preferred Provider Organization · La Mirada, CA
Provider details
- NPI number
- 1306115795
- Entity type
- Organization
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Kevin Park, MD(562) 802-0208
Specialties & taxonomies
Managed Care Organizations
Practice location
15330 Valley View Ave Ste 1
La Mirada, CA 90638-5238
Phone: (562) 802-0208
Approximate (ZIP-level) locationGet directions
Mailing address
15330 Valley View Ave Ste 1
La Mirada, CA 90638-5238
Registry dates
- Enumerated
- 2011-12-14
- Last updated
- 2011-12-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.