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1ST INDUSTRIAL MEDICAL GROUP NPI 1689863995


NPI Information

NPI: 1689863995
Provider Name: 1ST INDUSTRIAL MEDICAL GROUP
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
1234 W CHAPMAN AVE
SUITE 204
ORANGE, CA
ZIP 92868
Phone: (714) 289-4693
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1ST INDUSTRIAL MEDICAL GROUP is a podiatrist in Orange, CA. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. 1ST INDUSTRIAL MEDICAL GROUP NPI is 1689863995. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1234 W CHAPMAN AVE
SUITE 204
ORANGE, CA
ZIP 92868-862
Phone: (714) 289-4693
Fax: (714) 289-4698

The provider's authorized official is Mark W Bennallack .
The authorized official title is Co Owner and has the following contact phone number (714) 289-4693.

The enumeration date for this NPI number is 10/23/2007 and was last updated on 6/24/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractorNo
2207LP2900XAnesthesiologyPain MedicineNo
3207R00000XInternal MedicineNo
4207XX0004XOrthopaedic SurgeryFoot and Ankle SurgeryNo
5208100000XPhysical Medicine & RehabilitationNo
62086S0122XSurgeryPlastic and Reconstructive SurgeryNo
7208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)No
8213E00000XPodiatristYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.