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Organization
SOUTHERN CALIFORNIA ORTHOPEDIC MEDICAL GROUP INC
Active
Organization
SOUTHERN CALIFORNIA ORTHOPEDIC MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW J MILES DC (OWNER)
(909) 941-3986
Entity
Organization
Contact information
Practice address
3602 INLAND EMPIRE BLVD, SUITE B 120, ONTARIO, CA 91764-4900
(909) 941-3986
(909) 941-3988
Mailing address
3602 INLAND EMPIRE BLVD, SUITE B 120, ONTARIO, CA 91764-4900
(909) 941-3986
(909) 941-3988
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
171100000X
Acupuncturist
—
NULL
171100000X
Acupuncturist
—
—
174400000X
Specialist
—
NULL
174400000X
Specialist
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
NULL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
Other
Enumeration date
06/09/2009
Last updated
08/31/2016
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