Orthopaedic Medical Group of Riverside, Inc.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

ORTHOPAEDIC MEDICAL GROUP OF RIVERSIDE, INC.

Practice address

6800 Brockton Ave
2
Riverside, CA 92506-3810

Phone

(951) 774-4611

Fax

(951) 276-3597

NPI assigned

Mar 20, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Juan D Guajardo

Title

Ceo

Phone

(951) 774-4611

Specialties & licenses 1

Addresses

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302739200000",
    "number": "1144491895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 BROCKTON AVE",
            "address_2": "2",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063810",
            "telephone_number": "951-774-4611",
            "fax_number": "951-276-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 BROCKTON AVE",
            "address_2": "2",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063810",
            "telephone_number": "951-774-4611",
            "fax_number": "951-276-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC MEDICAL GROUP OF RIVERSIDE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2011-04-14",
        "status": "A",
        "authorized_official_last_name": "GUAJARDO",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-774-4611"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Abelina Ortega
• Uriel Ortega
• Yvonne Marie Ortega
• James A. Ortego, M.A.
• Orthopaedic Medical Group of Riverside, Inc.
• Orthopaedic Medical Group of Riverside, Inc.
• Orthopaedic Medical Group of Riverside, Inc.
• Orthopaedic Medical Group of Riverside, Inc.
• Orthopaedic Medical Group of Riverside, Inc.
• Orthopaedic Medical Group of Riverside, Inc.

• Orthopaedic Surgery Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.