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Organization
PERFORMANCE MEDICAL GROUP
Active
Organization
PERFORMANCE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE FREIRE (OFFICE MANAGER)
(760) 242-5055
Entity
Organization
Contact information
Practice address
16130 KOKANEE RD STE 101, APPLE VALLEY, CA 92307-0833
(760) 242-5055
(760) 242-5466
Mailing address
16130 KOKANEE RD STE 101, APPLE VALLEY, CA 92307-0833
(760) 242-5055
(760) 242-5466
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
225100000X
Physical Therapist
—
—
Other
Enumeration date
12/19/2012
Last updated
12/19/2012
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