MISSION ORTHOPEDICS SURGERY AND SPORTS MEDICINE (NPI# 1770699282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770699282 |
| Entity Type | Organization |
| Organization Name | MISSION ORTHOPEDICS SURGERY AND SPORTS MEDICINE |
| Practice Address |
1201 E Ocean Ave Suite B Lompoc CA 93436-7081 |
| Mailing Address |
Po Box 50706 Santa Barbara CA 93150-0706 |
| Practice Telephone | 8059633336 |
| Practice Fax Number | 8055643332 |
| Mailing Telephone | 8059633336 |
| Mailing Fax Number | 8055643332 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. COLVIN CLAY WELLBORN (PRESIDENT) |
| Authorized Official Telephone | 8059633336 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G846660 | 05 |
| Street Address |
1201 E OCEAN AVE SUITE B |
| City | LOMPOC |
| State | CA |
| Zip Code | 93436-7081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265423487 | Thomas S. Lossing | Internal Medicine | 1201 E Ocean Ave, Suite A, Lompoc, CA 93436-7081 | 2005-11-04 |
| 1619514841 | Mitchell D Ganz | Clinic/Center | 1201 E Ocean Ave, Lompoc, CA 93436-7081 | 2019-12-06 |
| 1720638646 | Vagner Carvalho Dachao | Physical Therapy Assistant | 1201 E Ocean Ave, Lompoc, CA 93436-7081 | 2019-09-12 |
| 1588147300 | Brian Lippner | Physical Therapy Assistant | 1201 E Ocean Ave, Lompoc, CA 93436-7081 | 2018-09-07 |
| 1790136810 | Ericson Dental Group-lompoc | Dentist | 1201 E Ocean Ave, Ste. G, Lompoc, CA 93436-7081 | 2016-06-30 |
| 1841667771 | Owen Michael Johnston | Physical Therapist | 1201 E Ocean Ave, Suite A, Lompoc, CA 93436-7081 | 2015-08-26 |
| 1699831743 | Jeffrey Edward Calhoun | Dentist | 1201 E Ocean Ave, Suite D, Lompoc, CA 93436-7081 | 2006-12-30 |
| 1619993045 | Thomas S. Lossing Inc. Amc | Internal Medicine | 1201 E Ocean Ave, Suite A, Lompoc, CA 93436-7081 | 2006-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671498 | Bonnie O'brien | Technician | 4174 Sirius Avenue, Lompoc, CA 93436 | 2019-10-21 |
| 1043734056 | Stevens Life Chiropractic, PC | Chiropractor | 217-a West Central Ave, Lompoc, CA 93436 | 2017-08-01 |
| 1548621014 | Kimberly Gaynell Wiley | Home Health Aide | 610 East Pine St #34, Lompoc, CA 93436 | 2016-03-11 |
| 1386017960 | Marcos Paul Cline | Counselor | 117 North 'b' Street, Lompoc, CA 93436 | 2015-11-04 |
| 1487045324 | Angela Rose Robinson | Case Manager/Care Coordinator | 113 North H Street, Suite F, Lompoc, CA 93436 | 2015-02-13 |
| 1851795751 | Alina Staniger | Counselor | 604 W Ocean, Lompoc, CA 93436 | 2014-10-21 |
| 1154750560 | Lompoc Valley Medical Center | General Acute Care Hospital | 303 South C Street, Lompoc, CA 93436 | 2013-11-06 |
| 1598191488 | David Lewis Mcaninch Iv | Dentist | 1111 East Ocean Avenue, Suite 9, Lompoc, CA 93436 | 2013-09-24 |
| 1336407048 | Pamela Jordan | Counselor | 110 S. 'c' St. Ste. A, Family Service Agency, Lompoc, CA 93436 | 2012-05-01 |
| 1316220874 | Zillah J. Hodgkins | Counselor | 513 N G St, Lompoc, CA 93436 | 2011-09-21 |
| Find all providers in zip 93436 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710098660 | David Anthony Thiede Cortese | Orthopaedic Surgery | 1025 E Ocean Ave Ste A, Lompoc, CA 93436-7088 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790341618 | Casey S Revenko | Orthopaedic Surgery | 2999 Regent St Ste 225, Berkeley, CA 94705-2117 | 2019-05-15 |
| 1225504301 | Amgad Alfred | Orthopaedic Surgery | 18145 Us Highway 18 Ste D, Apple Valley, CA 92307-2210 | 2018-10-16 |
| 1386136430 | Valley River Orthopedics and Sports Medicine | Orthopaedic Surgery | Valley River Orthopedics & Sports Medicine Inc, 3329 G St Ste A, Merced, CA 95340 | 2018-06-05 |
| 1073026696 | Optimal Physician Surgical Group | Orthopaedic Surgery | 25067 Jim Bridger Rd, Hidden Hills, CA 91302-1128 | 2017-11-06 |
| 1336669456 | Beach Cities Orthopedics Surgery Center, LLC | Orthopaedic Surgery | 400 S Sepulveda Blvd Ste 110, Manhattan Beach, CA 90266-6814 | 2017-06-20 |
| 1750818860 | Health Link Medical Group Inc | Orthopaedic Surgery | 899 Northgate Dr Ste 400, San Rafael, CA 94903-3667 | 2017-05-19 |
| 1962861476 | Mehta Orthopedics | Orthopaedic Surgery | 32145 Alvarado Niles Rd Ste 209, Union City, CA 94587-2930 | 2016-02-12 |
| 1649646282 | Bay Area Surgical Specialists, Inc. A Medical Corporation | Orthopaedic Surgery | 5924 Stoneridge Dr Ste 202, Pleasanton, CA 94588-5400 | 2015-08-18 |
| 1114346111 | Sean Robinson | Orthopaedic Surgery | 7551 Timberlake Way Ste 200, Sacramento, CA 95823-5422 | 2014-04-08 |
| 1851717938 | William R Campbell Do Prof Corp | Orthopaedic Surgery | 1 Daniel Burnham Ct Ste 365c, San Francisco, CA 94109-5490 | 2014-03-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.