Provider Demographics
NPI:1235964537
Name:SAN BERNARDINO MEDICAL ORTHOPAEDIC GROUP, INC.
Entity type:Organization
Organization Name:SAN BERNARDINO MEDICAL ORTHOPAEDIC GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIRONTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-557-1600
Mailing Address - Street 1:1801 ORANGE TREE LN STE 240
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-4587
Mailing Address - Country:US
Mailing Address - Phone:909-557-1600
Mailing Address - Fax:909-557-1740
Practice Address - Street 1:845 HIGHLAND SPRINGS AVE STE 101
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-5789
Practice Address - Country:US
Practice Address - Phone:909-500-7860
Practice Address - Fax:909-500-7873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty