Provider Demographics
NPI:1063439875
Name:PALOMAR ORTHOPAEDIC SPECIALISTS, APMC
Entity type:Organization
Organization Name:PALOMAR ORTHOPAEDIC SPECIALISTS, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:M
Authorized Official - Last Name:O'MEARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-743-0100
Mailing Address - Street 1:255 N ELM ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3431
Mailing Address - Country:US
Mailing Address - Phone:760-743-0100
Mailing Address - Fax:760-743-1414
Practice Address - Street 1:255 N ELM ST
Practice Address - Street 2:SUITE 105
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3431
Practice Address - Country:US
Practice Address - Phone:760-743-0100
Practice Address - Fax:760-743-1414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG66518174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG66518Medicare ID - Type Unspecified
CA1002190001Medicare NSC
CAW13415Medicare ID - Type Unspecified
CAF11804Medicare UPIN