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General NPI Number Information
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NPI Number | 1194722801
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Entity Type | Organization
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Legal Business Name | PACIFIC ORTHOPAEDIC MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 06/11/2024
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Provider Practice Location Address
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Address Line | 707 S GARFIELD AVE SUITE 201
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City | ALHAMBRA
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State | CA
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Zip | 91801-5859
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Country | US
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Telephone | 626-656-1324
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Fax | 626-289-5700
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Provider Business Mailing Address
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Address Line | PO BOX 25706
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City | PASADENA
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State | CA
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Zip | 91185-5706
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Country | US
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Telephone | 626-282-1600
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Fax | 626-656-1264
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Authorized Official
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Title or Position | ACCOUNTS RECEIVABLE MANAGER
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Name | SARAH P DU
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Credential |
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Telephone | 626-656-1324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | CA
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