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Organization
CORONA ORTHOPAEDIC ASSOCIATES MEDICAL GROUP INC
Active
Organization
CORONA ORTHOPAEDIC ASSOCIATES MEDICAL GROUP INC
Active
Other names
Corona-Temecula Orthopaedic Associates Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY LLOYD BAUM MD (SECRETARY)
(951) 735-6060
Entity
Organization
Contact information
Practice address
341 MAGNOLIA AVENUE, SUITE 101, CORONA, CA 92879-3331
(951) 735-6060
(951) 735-4510
Mailing address
341 MAGNOLIA AVENUE, SUITE 101, CORONA, CA 92879-3331
(951) 735-6060
(951) 735-4510
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
—
925392B
—
CA
01
—
CI7854
RAIL ROAD MEDICARE
—
05
—
GR0070300
—
CA
01
—
ZZZ51830Z
BLUE SHIELD OF CALIFORNIA
—
Enumeration date
08/24/2006
Last updated
02/03/2023
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