| Regenerative Medical Group Inc | |
|
615 E Chapman Ave Orange CA 92866-1643 | |
| (714) 639-4012 | |
| (714) 639-4018 |
| Full Name | Regenerative Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 615 E Chapman Ave, Orange, California |
| Authorized Official Name and Position | Bryn J Henderson (DIRECTOR) |
| Authorized Official Contact | 7149818058 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regenerative Medical Group Inc 615 E Chapman Ave Orange CA 92866-1643 Ph: (714) 639-4012 | Regenerative Medical Group Inc 615 E Chapman Ave Orange CA 92866-1643 Ph: (714) 639-4012 |
| NPI Number | 1013328277 |
|---|---|
| Provider Enumeration Date | 05/09/2014 |
| Last Update Date | 03/20/2017 |
| Medicare PECOS PAC ID | 3779707674 |
|---|---|
| Medicare Enrollment ID | O20140616001959 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013328277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Bryn J Henderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447296694 PECOS PAC ID: 1557258928 Enrollment ID: I20040302000547 |
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