# ORANGE COUNTY MEDICAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104153113
- **Authorized official:** ROSEANN GONZALEZ (PRESIDENT)
- **Authorized official phone:** (714) 808-9292

## Contact information

- **Practice address:** 1211 W LA PALMA AVE STE 709, ANAHEIM, CA 92801-2814
- **Practice address phone:** (714) 808-9292
- **Mailing address:** 1211 W LA PALMA AVE STE 709, ANAHEIM, CA 92801-2814

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | G84446 | CA | Yes |

## Other

- **Enumeration date:** 11/11/2009
- **Last updated:** 11/11/2009