Optimal Orthopedic Medical Group

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G53516 Issued in CA

Legal business name

OPTIMAL ORTHOPEDIC MEDICAL GROUP

Practice address

17400 Irvine Blvd Ste L
Tustin, CA 92780-3030

Phone

(714) 434-8663

NPI assigned

Nov 6, 2007

Organization subpart

No

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

Authorized official

Name

Jessica Roger

Title

Office Manager

Phone

(714) 434-8663

Specialties & licenses 1

Addresses

Locations

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": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1881874998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926590109",
            "telephone_number": "714-434-8663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17400 IRVINE BLVD STE L",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803030",
            "telephone_number": "714-434-8663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL ORTHOPEDIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "ROGER",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "714-434-8663"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G53516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orange County Foot & Ankle Group, Inc.

• Orthopaedic Surgery Physician in Tustin, CA
• Providers in Tustin, 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 Nov 6, 2007; 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.