Organization
ALPINE ORTHOPAEDIC MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNE DUNN MCCUNE MS HSA (PRACTICE ADMINISTRATION)
(209) 946-7139
Entity
Organization
Contact information
Practice address
2488 N. CALIFORNIA ST, STOCKTON, CA 95204-5508
(209) 948-3333
(209) 948-3330
Mailing address
2488 N. CALIFORNIA ST, STOCKTON, CA 95204-5508
(209) 948-3333
(209) 948-3330
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
207XX0801X
Orthopaedic Trauma Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0368640001
DMERC SUPPLIER NUMBER
CA
01
—
195690700
USDL
—
01
—
CGP159090
CGP #
—
05
—
ZZZ71793Z
—
CA
Enumeration date
11/02/2006
Last updated
01/18/2023
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