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NPI 1689863995

OrganizationActive

1st Industrial Medical Group

NPI 1689863995 · Podiatrist · Orange, CA

Provider details

NPI number: 1689863995
Entity type: Organization
Primary specialty: PodiatristPodiatric Medicine & Surgery Service Providers
Authorized official: Mark Bennallack, Co Owner

Practice location

1234 W Chapman Ave

Suite 204

Orange, CA 92868-2862

Phone: (714) 289-4693

Fax: (714) 289-4698

More CA providers

Mailing address

1234 W Chapman Ave

Orange, CA 92868-2862

Registry dates

Enumerated: 2007-10-23
Last updated: 2008-06-24

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

1st Industrial Medical Group — NPI 1689863995, Orange, CA | NPI Central