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Organization
ORCHID MEDICAL GROUP
Active
Organization
ORCHID MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLISE NEGRETTE (ACCOUNT MANAGER)
(909) 793-5511
Entity
Organization
Contact information
Practice address
395 TERRACINA BLVD, REDLANDS, CA 92373-4849
(951) 323-1907
Mailing address
5917 SPEYSIDE RD, RIVERSIDE, CA 92507-8475
(951) 323-1907
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A064957
CA
Other
Enumeration date
11/30/2016
Last updated
03/31/2017
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