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Organization
ORTHOSOURCE MEDICAL CLINICS INC, DBA ORTHOCENTER MEDICAL GROUP INC
Active
Organization
ORTHOSOURCE MEDICAL CLINICS INC, DBA ORTHOCENTER MEDICAL GROUP INC
Active
Other names
ORTHOCENTER Medical Group Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAY ALLEN MARTIN (PRESIDENT/ADMINISTRATOR)
(626) 449-0933
Entity
Organization
Contact information
Practice address
425 FAIR OAKS, SUITE A, PASADENA, CA 91105-2632
(626) 744-0434
(626) 449-0934
Mailing address
425 FAIR OAKS, SUITE A, PASADENA, CA 91105-2632
(626) 744-0434
(626) 449-0934
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G045078
CA
Other
Enumeration date
11/07/2006
Last updated
07/26/2013
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