Organization Active NPI

Orthopaedic Medical Group of Riverside, Inc.

  • Orthopaedic Surgery Physician
  • Riverside, CA
National Provider Identifier
1477512671
Registry record updated Mar 17, 2011
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
6800 Brockton Ave
Riverside, CA 92506-3810
Phone
(951) 683-0650
Fax
(951) 276-3569
NPI assigned
Mar 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Authorized official

Name
Juan D Guajardo Sr.
Title
Chief Executive Officer
Phone
(951) 774-4611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

6800 Brockton Ave
Riverside, CA 92506-3810

Mailing address

6800 Brockton Ave
Suite 2
Riverside, CA 92506-3810
Phone (951) 774-4611

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1477512671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 BROCKTON AVE",
            "address_2": "SUITE 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",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063810",
            "telephone_number": "951-683-0650",
            "fax_number": "951-276-3569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC MEDICAL GROUP OF RIVERSIDE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "GUAJARDO",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "951-774-4611",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 17, 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.