Healthcare Provider Details

I. General information

NPI: 1154230209
Provider Name (Legal Business Name): MEDBRIDGE HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10891 FENTON RD
MORENO VALLEY CA
92557-4037
US

IV. Provider business mailing address

10891 FENTON RD
MORENO VALLEY CA
92557-4037
US

V. Phone/Fax

Practice location:
  • Phone: 307-289-2158
  • Fax:
Mailing address:
  • Phone: 307-289-2158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ASHER JOHN
Title or Position: OWNER
Credential:
Phone: 307-289-2158