Provider Demographics
NPI:1578130241
Name:SAH ORTHOPAEDIC ASSOCIATES
Entity type:Organization
Organization Name:SAH ORTHOPAEDIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHUCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-818-7210
Mailing Address - Street 1:2000 MOWRY AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1716
Mailing Address - Country:US
Mailing Address - Phone:510-818-7210
Mailing Address - Fax:510-818-5015
Practice Address - Street 1:1320 EL CAPITAN DR STE 200
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-6260
Practice Address - Country:US
Practice Address - Phone:510-818-7200
Practice Address - Fax:510-818-8710
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAH ORTHOPAEDIC ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty