Organization
GORUM ORTHOPEDICS & ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDELL J GORUM II MD (DIRECTOR)
(209) 342-2300
Entity
Organization
Contact information
Practice address
1199 DELBON AVE, STE 1, TURLOCK, CA 95382-2015
(209) 342-2300
(209) 524-4240
Mailing address
4301 NORTH STAR WAY, MODESTO, CA 95356
(209) 342-2300
(209) 524-4240
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A791190
BLUE SHIELD
—
05
—
00A791190
—
CA
Enumeration date
07/08/2005
Last updated
07/21/2022
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