Provider Demographics
NPI:1679313563
Name:DR JOHN ATTENELLO MD APC
Entity type:Organization
Organization Name:DR JOHN ATTENELLO MD APC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:ATTENELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-337-2589
Mailing Address - Street 1:1513 S GRAND AVE STE 380
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3070
Mailing Address - Country:US
Mailing Address - Phone:310-337-2589
Mailing Address - Fax:
Practice Address - Street 1:1513 S GRAND AVE STE 380
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3070
Practice Address - Country:US
Practice Address - Phone:310-337-2589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR JOHN ATTENELLO MD APC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-29
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty