PROVIDENCE HEALTHCARE INC
NPI 1760984033
Orthopaedic Surgery in Marina Del Rey, CA
NPI Status: Active since March 02, 2018
Contact Information
13160 MINDANAO WAY
MARINA DEL REY, CA
ZIP 90292
Phone: (310) 437-7923
Fax: (310) 561-1927
- Organization
- Orthopaedic Surgery
- CLIA Number: 05D2142176
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-03-2026
About PROVIDENCE HEALTHCARE INC
This page provides the complete NPI Profile along with additional information for Providence Healthcare Inc, a provider established in Marina Del Rey, California operating as a Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1760984033 assigned on March 2018. The practitioner's primary taxonomy code is 207X00000X with license number G056259 (CA). The provider is registered as an organization and their NPI record was last updated 8 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dean Matsuda Md (President)
- NPI
- 1760984033
- Provider Name
- PROVIDENCE HEALTHCARE INC
- Entity Type
- Organization
- Location Address
- 13160 MINDANAO WAY MARINA DEL REY, CA 90292
- Location Phone
- (310) 437-7923
- Location Fax
- (310) 561-1927
- Mailing Address
- 214 MAIN ST EL SEGUNDO, CA 90245
- Mailing Phone
- (310) 322-4278
- Mailing Fax
- (310) 561-1927
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-02-2018
- Last Update Date
- 03-02-2018
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Orthopaedic Surgery
- Taxonomy Code
- 207X00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- G056259
- License State
- CA
- Taxonomy Description
- An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2142176
- Facility Type
- Physician Office
- Certificate Effective Date
- January 04, 2024
- Certificate Expiration Date
- January 03, 2026
- Laboratory Director
- ALLEN H. PACHTMAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Providence Healthcare Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1760984033, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
MARINA DEL REY, CA 90292
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760984033, enumerated as an "organization" on March 02, 2018.
The provider is located at 13160 MINDANAO WAY MARINA DEL REY, CA 90292 and the phone number is (310) 437-7923.
Orthopaedic Surgery with taxonomy code 207X00000X.
