Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Spondylos Medical Group, Inc

Organization Orthopaedic Surgery of the Spine Physician · NPI 1104038587

Spondylos Medical Group, Inc is an Orthopaedic Surgery of the Spine Physician in LA Jolla, California. Licensed in California. Registered with an NPI since 2007.

Licensed in
CA
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4130 La Jolla Village Dr Ste 300
LA Jolla, CA 92037-9121
Phone: (858) 587-0700
Fax: (858) 587-0401
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery of the Spine Physician (primary) Taxonomy 207XS0117X · Licence G35628 (CA)

Record details

NPI number1104038587
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bruce Van Dam — President · (858) 587-0700
NPI enumeratedMay 5, 2007
Last updated in NPPESAugust 22, 2020
Mailing address4130 La Jolla Village Dr, Suite 300, La Jolla, CA 92037-9121

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