Organization
ORTHOPAEDIC MEDICAL GROUP OF RIVERSIDE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN D GUAJARDO (CHIEF EXCUTIVE OFFICER)
(951) 774-4611
Entity
Organization
Contact information
Practice address
29099 HOSPITAL ROAD, SUITE 112, LAKE ARROWHEAD, CA 92352
(909) 337-9300
(909) 337-6440
Mailing address
6850 BROCKTON AVE, SUITE 212, RIVERSIDE, CA 92506-3808
(951) 774-4611
(951) 276-3597
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
C42773
CA
Other
Enumeration date
08/11/2006
Last updated
03/05/2008
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