Orthodontics Only

Specialty details in registry · Hawthorne, CA

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At a glance

11633 Hawthorne Blvd, Hawthorne, CA 90250-2321

NPPES record updated Apr 27, 2016. Public records can lag behind changes at a practice.

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Practice location

11633 Hawthorne Blvd Ste. 500
Hawthorne, CA 90250-2321

Professional details: NPI, taxonomy & registry record

NPI1730534751

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 1223X0400X
Enumeration date: Apr 27, 2016
Record updated: Apr 27, 2016

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

1223X0400X · Primary

License reported: 17997 CA

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

11633 Hawthorne Blvd
Ste. 500
Hawthorne, CA 90250-2321

Phone: (310) 644-4412
Fax: (310) 644-7355

Mailing address

11633 HAWTHORNE BLVD
STE. 500
HAWTHORNE, CA 902502321

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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