Provider Demographics
NPI:1053965665
Name:RANCHO ORTHOPEDICS A MEDICAL GROUP INC
Entity type:Organization
Organization Name:RANCHO ORTHOPEDICS A MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUFUS
Authorized Official - Middle Name:
Authorized Official - Last Name:GORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-972-4580
Mailing Address - Street 1:41990 COOK ST STE C302
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-6101
Mailing Address - Country:US
Mailing Address - Phone:760-972-4580
Mailing Address - Fax:760-972-4586
Practice Address - Street 1:41990 COOK ST STE C302
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6101
Practice Address - Country:US
Practice Address - Phone:760-972-4580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty