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Organization
ALPINE ORTHOPAEDIC MEDICAL GROUP INC
Active
Organization
ALPINE ORTHOPAEDIC MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNE DUNN MCCUNE MS HSA (PRACTICE ADMINISTRATION)
(209) 946-7139
Entity
Organization
Contact information
Practice address
2488 N. CALIFORNIA ST, STOCKTON, CA 95204-5508
(209) 948-3333
(209) 948-3330
Mailing address
2488 N. CALIFORNIA ST, STOCKTON, CA 95204-5508
(209) 948-3333
(209) 948-3330
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
NULL
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
NULL
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
NULL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
NULL
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
NULL
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
NULL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
207XX0801X
Orthopaedic Trauma Physician
—
NULL
207XX0801X
Orthopaedic Trauma Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0368640001
DMERC SUPPLIER NUMBER
CA
01
—
195690700
USDL
—
01
—
CGP159090
CGP #
—
05
—
ZZZ71793Z
—
CA
Enumeration date
11/02/2006
Last updated
01/18/2023
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