Organization
RUSSELL JOHN MOLINA
Active
Other names
Coachella Valley Orthopedic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL J MOLINA CPO (OWNER)
(760) 345-4779
Entity
Organization
Contact information
Practice address
73345 HIGHWAY 111, STE 102, PALM DESERT, CA 92260-3909
(760) 345-4779
(760) 772-3904
Mailing address
73345 HIGHWAY 111, STE 102, PALM DESERT, CA 92260-3909
(760) 345-4779
(760) 772-3904
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XC0026070
—
CA
Enumeration date
07/06/2007
Last updated
07/29/2008
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