# CORONA ORTHOPAEDIC ASSOCIATES MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Corona-Temecula Orthopaedic Associates Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598872657
- **Authorized official:** BRADLEY LLOYD BAUM MD (SECRETARY)
- **Authorized official phone:** (951) 735-6060

## Contact information

- **Practice address:** 341 MAGNOLIA AVENUE, SUITE 101, CORONA, CA 92879-3331
- **Practice address phone:** (951) 735-6060
- **Practice address fax:** (951) 735-4510
- **Mailing address:** 341 MAGNOLIA AVENUE, SUITE 101, CORONA, CA 92879-3331
- **Mailing address phone:** (951) 735-6060
- **Mailing address fax:** (951) 735-4510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/24/2006
- **Last updated:** 02/03/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 925392B | — | CA |
| 01 | — | CI7854 | RAIL ROAD MEDICARE | — |
| 05 | — | GR0070300 | — | CA |
| 01 | — | ZZZ51830Z | BLUE SHIELD OF CALIFORNIA | — |