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Organization
REGEN ORTHO CLINIC
Active
Organization
REGEN ORTHO CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW KEITH (PRESIDENT)
(626) 965-2334
Entity
Organization
Contact information
Practice address
2361 S AZUSA AVE, WEST COVINA, CA 91792-1537
(626) 965-2334
(626) 964-6504
Mailing address
2361 S AZUSA AVE, WEST COVINA, CA 91792-1537
(626) 965-2334
(626) 964-6504
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
—
NULL
111NN1001X
Nutrition Chiropractor
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
07/11/2015
Last updated
07/11/2015
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