Organization
EXECUTIVE MEDICAL & SURGICAL ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARREN L BERGEY MD (CEO)
(909) 824-2422
Entity
Organization
Contact information
Practice address
900 E WASHINGTON ST, SUITE 300, COLTON, CA 92324
(909) 824-2422
(909) 824-8234
Mailing address
PO BOX 894773, LOS ANGELES, CA 90189-4773
(909) 824-2422
(909) 824-8234
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Enumeration date
01/12/2007
Last updated
07/16/2015
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