Provider Demographics
NPI:1205869278
Name:TEMPLETON ORTHOPAEDICS
Entity type:Organization
Organization Name:TEMPLETON ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KRALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-434-1881
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465
Mailing Address - Country:US
Mailing Address - Phone:805-434-1881
Mailing Address - Fax:805-434-2794
Practice Address - Street 1:1111 LAS TABLAS RD
Practice Address - Street 2:STE R
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465
Practice Address - Country:US
Practice Address - Phone:805-434-1881
Practice Address - Fax:805-434-2794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG20328207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR00S4400Medicaid
CA=========OtherTAX ID
CAW12093Medicare ID - Type Unspecified
CAGR00S4400Medicaid