OrganizationActive
Orthopedic Specialists of North America, PLLC
NPI 1679937262 · Sports Medicine (Orthopaedic Surgery) Physician · San Tan Valley, AZ
Provider details
- NPI number
- 1679937262
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Orthopedic Specialists of North America, PLLC
- Authorized official
- Daleina Bulger, Credentialing Manager
- License
- 44763 (AZ)
Practice location
40601 N Gantzel Rd Ste 103
San Tan Valley, AZ 85140-7036
Phone: (602) 648-5444
Fax: (602) 772-3801
Mailing address
Po Box 80217
Phoenix, AZ 85060-0217
Registry dates
- Enumerated
- 2016-04-08
- Last updated
- 2022-07-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.