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Fullerton Orthopaedic Surgery Medical Group, INC.

Specialist in Huntington Beach, CA. Organization (NPI-2).

NPI number1174802433
StatusActive
Last updated in NPPESAug 4, 2011

Details

NPI
1174802433
Entity type
Organization (NPI-2)
Legal business name
Fullerton Orthopaedic Surgery Medical Group, INC.
Organization subpart
No
Enumeration date
Aug 4, 2011
Last updated
Aug 4, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
174400000X Specialist20A9973CAYes

Practice location

15039 Goldenwest St
Huntington Beach, CA 92647-2710

Phone 714-893-7400 · Fax 714-893-7022

Mailing address

101 Laguna Rd Ste A
Fullerton, CA 92835-3635

Phone 714-879-0050 · Fax 714-879-0249

Authorized official

Kendall Wagner
President
7148790050

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