Organization
PURI ORTHOPEDIC CENTER, INC.
Active
Organization
PURI ORTHOPEDIC CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEATA MOORE (BILLING MANAGER)
(760) 243-0464
Entity
Organization
Contact information
Practice address
12830 HESPERIA ROAD, SUITE A, VICTORVILLE, CA 92395-7788
(760) 243-7715
(760) 243-5442
Mailing address
12830 HESPERIA ROAD, SUITE A, VICTORVILLE, CA 92395-7788
(760) 243-7715
(760) 243-5442
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C500750
—
CA
Enumeration date
07/13/2006
Last updated
02/20/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up