Organization
ORTHOPAEDIC MEDICAL GROUP OF RIVERSIDE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY DEMERS DO (CREDENTIALING)
(951) 683-0650
Entity
Organization
Contact information
Practice address
1800 WESTERN AVE STE 106, SAN BERNARDINO, CA 92411-1352
(951) 683-0650
(951) 774-4612
Mailing address
4354 LATHAM ST STE 100, RIVERSIDE, CA 92501-1777
(951) 683-0650
(951) 774-4612
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ40607Z
—
CA
Enumeration date
06/11/2019
Last updated
06/11/2019
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