Provider Demographics
NPI:1922245075
Name:ADVANCED ORTHOPAEDIC MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:ADVANCED ORTHOPAEDIC MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:THAN TRONG NUYEN
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:951-600-1879
Mailing Address - Street 1:41680 IVY ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-9434
Mailing Address - Country:US
Mailing Address - Phone:951-600-1879
Mailing Address - Fax:951-600-1126
Practice Address - Street 1:41680 IVY ST
Practice Address - Street 2:SUITE A
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-9434
Practice Address - Country:US
Practice Address - Phone:951-600-1879
Practice Address - Fax:951-600-1126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22101111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty