Organization
ORTHOPAEDIC MEDICAL GROUP OF RIVERSIDE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN D GUAJARDO SR. (CHIEF EXECUTIVE OFFICER)
(951) 774-4611
Entity
Organization
Contact information
Practice address
6800 BROCKTON AVE, RIVERSIDE, CA 92506-3810
(951) 683-0650
(951) 276-3569
Mailing address
6800 BROCKTON AVE, SUITE 2, RIVERSIDE, CA 92506-3810
(951) 774-4611
(951) 276-3597
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
03/17/2006
Last updated
03/17/2011
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