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General NPI Number Information
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NPI Number | 1326196874
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Entity Type | Organization
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Legal Business Name | ADVANCED ORTHOPEDICS MEDICAL CORP
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 11/25/2009
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Provider Practice Location Address
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Address Line | 1560 W LACEY BLVD SUITE 101
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City | HANFORD
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State | CA
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Zip | 93230-3581
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Country | US
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Telephone | 559-589-6294
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Fax | 559-589-6295
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Provider Business Mailing Address
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Address Line | 1560 W LACEY BLVD SUITE 101
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City | HANFORD
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State | CA
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Zip | 93230-3581
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Country | US
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Telephone | 559-589-6294
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Fax | 559-589-6295
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. VICENTE BERNABE
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Credential |
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Telephone | 559-589-6294
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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 | 20A7405
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License Number State | CA
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