Healthcare Provider Details

I. General information

NPI: 1710826649
Provider Name (Legal Business Name): BLUE ORTHOPEDIC INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7042 HANFORD AVE
YUCCA VALLEY CA
92284-5946
US

IV. Provider business mailing address

7042 HANFORD AVE
YUCCA VALLEY CA
92284-5946
US

V. Phone/Fax

Practice location:
  • Phone: 909-278-7590
  • Fax:
Mailing address:
  • Phone: 909-278-7590
  • Fax:

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: DR. RANDALL JAMES ROY
Title or Position: OWNER
Credential: MD
Phone: 760-218-4447