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General NPI Number Information
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NPI Number | 1609994037
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL ORTHOPEDIC MEDICAL GROUP
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 82013 DOCTOR CARREON BLVD STE G
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City | INDIO
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State | CA
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Zip | 92201-5832
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Country | US
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Telephone | 760-775-9500
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Fax | 760-775-9567
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Provider Business Mailing Address
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Address Line | 31938 TEMECULA PKWY # A337
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City | TEMECULA
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State | CA
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Zip | 92592-6810
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Country | US
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Telephone | 714-414-3065
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID SCOTT JOHNSON
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Credential | MD
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Telephone | 702-283-0085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number |
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License Number State |
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