NPIMap

Organization Active NPI

Pacific Orthopaedic Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Alhambra, CA
National Provider Identifier
1194722801
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PACIFIC ORTHOPAEDIC MEDICAL GROUP, INC.
Practice address
707 S Garfield Ave
Suite 201
Alhambra, CA 91801-5859
Phone
(626) 656-1324
Fax
(626) 289-5700
NPI assigned
Jul 7, 2005
Last updated
Jun 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Authorized official

Name
Sarah P Du
Title
Accounts Receivable Manager
Phone
(626) 656-1324

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X CA Primary

Addresses

Primary practice location

707 S Garfield Ave
Suite 201
Alhambra, CA 91801-5859

Mailing address

PO Box 25706
Pasadena, CA 91185-5706
Phone (626) 282-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040625001148 CA Part B Supplier - Clinic/Group Practice 6204812670 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
Practice locations: City of Industry, CA; Alhambra, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718064000000",
    "number": "1194722801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25706",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911855706",
            "telephone_number": "626-282-1600",
            "fax_number": "626-656-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S GARFIELD AVE",
            "address_2": "SUITE 201",
            "city": "ALHAMBRA",
            "state": "CA",
            "postal_code": "918015859",
            "telephone_number": "626-656-1324",
            "fax_number": "626-289-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC ORTHOPAEDIC MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A",
        "authorized_official_last_name": "DU",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE MANAGER",
        "authorized_official_telephone_number": "626-656-1324"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alhambra, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.