Provider Demographics
NPI:1497294821
Name:ORTHOPEDIC AND PHYSICAL MEDICINE ASSOCIATES INC
Entity Type:Organization
Organization Name:ORTHOPEDIC AND PHYSICAL MEDICINE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:DUFFNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-325-8677
Mailing Address - Street 1:81765 HWY 111
Mailing Address - Street 2:#3
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201
Mailing Address - Country:US
Mailing Address - Phone:760-863-5955
Mailing Address - Fax:760-863-5655
Practice Address - Street 1:81765 HWY 111
Practice Address - Street 2:#3
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201
Practice Address - Country:US
Practice Address - Phone:760-863-5955
Practice Address - Fax:760-863-5655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23477111N00000X
CAG87277207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty