Healthcare Provider Details
I. General information
NPI: 1306178686
Provider Name (Legal Business Name): UNITED ORTHOPAEDIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/11/2010
Last Update Date: 02/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15990 TUSCOLA RD
APPLE VALLEY CA
92307-2111
US
IV. Provider business mailing address
15990 TUSCOLA RD
APPLE VALLEY CA
92307-2111
US
V. Phone/Fax
- Phone: 760-242-4808
- Fax: 760-242-4889
- Phone: 760-242-4808
- Fax: 760-242-4889
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SAMUEL
H
RICE
Title or Position: PRESIDENT
Credential: MD
Phone: 760-242-4808