NPIMap

Organization Active NPI

Orthopaedic Medical Group of Riverside, Inc.

  • Orthopaedic Surgery Physician
  • Riverside, CA
National Provider Identifier
1215107354
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPAEDIC MEDICAL GROUP OF RIVERSIDE, INC.
Practice address
6850 Brockton Ave
Suite 212
Riverside, CA 92506-3808
Phone
(951) 774-4611
Fax
(951) 276-3597
NPI assigned
Mar 5, 2008
Last updated
Mar 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PSY 11922 CA
Orthopaedic Surgery Physician 207X00000X NU Primary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X A69385 CA
Physical Therapist 225100000X NU

Addresses

Primary practice location

6850 Brockton Ave
Suite 212
Riverside, CA 92506-3808

Mailing address

6850 Brockton Ave
Suite 212
Riverside, CA 92506-3808
Phone (951) 774-4611

National Provider Directory

National Provider Directory
Tax ID family
Aim Hi Therapy Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1215107354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 BROCKTON AVE",
            "address_2": "SUITE 212",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063808",
            "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": "6850 BROCKTON AVE",
            "address_2": "SUITE 212",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063808",
            "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": "2008-03-05",
        "last_updated": "2008-03-05",
        "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": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY 11922",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A69385",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.