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Organization
ORTHOPAEDIC MEDICAL GROUP OF RIVERSIDE, INC.
Active
Organization
ORTHOPAEDIC MEDICAL GROUP OF RIVERSIDE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY DEMERS DO (CREDENTIALING)
(951) 683-0650
Entity
Organization
Contact information
Practice address
1800 WESTERN AVE STE 106, SAN BERNARDINO, CA 92411-1352
(951) 683-0650
(951) 774-4612
Mailing address
4354 LATHAM ST STE 100, RIVERSIDE, CA 92501-1777
(951) 683-0650
(951) 774-4612
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ40607Z
—
CA
Enumeration date
06/11/2019
Last updated
06/11/2019
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