Organization
ORANGE ORTHOPEDIC MEDICA GP, INC. THE PROVIDENCE BLDG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACY THORNE (BILLING SPECIALIST)
(714) 538-8549
Entity
Organization
Contact information
Practice address
1310 W STEWART DR STE 410, ORANGE, CA 92868-3855
(714) 538-8549
(714) 538-1547
Mailing address
1310 W STEWART DR STE 410, ORANGE, CA 92868-3855
(714) 538-8549
(714) 538-1547
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0003520
—
CA
Enumeration date
10/05/2005
Last updated
06/23/2023
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