Citrus Orthopaedic Medical Group Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A18600 Issued in CA

Legal business name

CITRUS ORTHOPAEDIC MEDICAL GROUP INC.

Practice address

315 N 3Rd Ave
Suite 200
Covina, CA 91723-1905

Phone

(626) 339-7325

Fax

(626) 915-4956

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Charles B MC Elwee Jr., M.D.

Title

President

Phone

(626) 339-7325

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821147711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N 3RD AVE",
            "address_2": "SUITE 200",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231905",
            "telephone_number": "626-339-7325",
            "fax_number": "626-915-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N 3RD AVE",
            "address_2": "SUITE 200",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231905",
            "telephone_number": "626-339-7325",
            "fax_number": "626-915-4956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITRUS ORTHOPAEDIC MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MC ELWEE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-339-7325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A18600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER FOR INDIVIDUAL",
            "identifier": "1508867367",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Esther Bravo Cisneros, BHT
• Karen Cisneros
• Maria Del Rosario Cisneros, LCSW
• Citrus Dialysis Center, Inc.
• Citrus Family Practice Inc
• Citrus Psychiatric Medical Clinic, Inc.
• Citrus Valley Health Partners
• Lionel Herbert Clack
• Azia Monique Clark
• Lara M Clark, PA-C

• Specialist in Covina, CA
• Providers in Covina, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.