MEDICARE: CALIFORNIA ORTHOPAEDIC INSTITUTE MEDICAL ASSOCIATES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1558209064
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALIFORNIA ORTHOPAEDIC INSTITUTE MEDICAL ASSOCIATES INC

Provider Business Mailing Address
First Line	:	7485 MISSION VALLEY RD STE 104A
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-4422
Country	:	US
Telephone Number	:	619-291-8930
Fax Number	:	619-291-8491

Provider Business Practice Location Address
First Line	:	1665 S IMPERIAL AVE STE C
Second Line	:
City	:	EL CENTRO
State	:	CA
Zip	:	92243-4247
Country	:	US
Telephone Number	:	760-335-4943
Fax Number	:	760-337-8400

Authorized Official
Title or Position	:	PARTNER
Name	:	LESTER RANDALL MOHLER
Credential	:
Telephone Number	:	619-291-8930

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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