# GAREY ORTHOPEDIC MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669764205
- **Authorized official:** DR. JAMES C. LILLEY M.D. (PARTNER)
- **Authorized official phone:** (909) 593-7437

## Contact information

- **Practice address:** 7777 MILLIKEN AVE STE A, SUITE 101, RANCHO CUCAMONGA, CA 91730-6778
- **Practice address phone:** (909) 987-7696
- **Practice address fax:** (909) 593-1958
- **Mailing address:** 255 E BONITA AVE STE 101, POMONA, CA 91767-1923
- **Mailing address phone:** (909) 593-7437
- **Mailing address fax:** (909) 593-1958

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | A45892 | CA | Yes |
| 207X00000X | Orthopaedic Surgery Physician | C28115 | CA | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | G81163 | CA | — |
| 207XS0114X | Adult Reconstructive Orthopaedic Surgery Physician | G61462 | CA | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | A100701 | CO | — |

## Other

- **Enumeration date:** 05/13/2011
- **Last updated:** 02/03/2020