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Organization
ORANGE ORTHOPEDIC MEDICA GP, INC. THE PROVIDENCE BLDG
Active
Organization
ORANGE ORTHOPEDIC MEDICA GP, INC. THE PROVIDENCE BLDG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACY THORNE (BILLING SPECIALIST)
(714) 538-8549
Entity
Organization
Contact information
Practice address
1310 W STEWART DR STE 410, ORANGE, CA 92868-3855
(714) 538-8549
(714) 538-1547
Mailing address
1310 W STEWART DR STE 410, ORANGE, CA 92868-3855
(714) 538-8549
(714) 538-1547
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
—
GR0003520
—
CA
Enumeration date
10/05/2005
Last updated
06/23/2023
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