Healthcare Provider Details

I. General information

NPI: 1558209064
Provider Name (Legal Business Name): CALIFORNIA ORTHOPAEDIC INSTITUTE MEDICAL ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1665 S IMPERIAL AVE STE C
EL CENTRO CA
92243-4247
US

IV. Provider business mailing address

7485 MISSION VALLEY RD STE 104A
SAN DIEGO CA
92108-4422
US

V. Phone/Fax

Practice location:
  • Phone: 760-335-4943
  • Fax: 760-337-8400
Mailing address:
  • Phone: 619-291-8930
  • Fax: 619-291-8491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LESTER RANDALL MOHLER
Title or Position: PARTNER
Credential:
Phone: 619-291-8930