Podiatrist
1ST INDUSTRIAL MEDICAL GROUP
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1689863995 · enumerated 2007-10-23 · record updated 2008-06-24. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: MARK BENNALLACK, Co Owner · (714) 289-4693
Addresses and phones
- Mailing address 1234 W CHAPMAN AVE, SUITE # 204, ORANGE, CA, 92868-2862 (714) 289-4693 Fax (714) 289-4698 Google Maps Apple Maps OpenStreetMap
- Practice location 1234 W CHAPMAN AVE, SUITE 204, ORANGE, CA, 92868-2862 (714) 289-4693 Fax (714) 289-4698 Google Maps Apple Maps OpenStreetMap
Specialties
- Chiropractor 111N00000X
- Anesthesiology, Pain Medicine 207LP2900X
- Internal Medicine 207R00000X
- Orthopaedic Surgery, Foot and Ankle Surgery 207XX0004X
- Physical Medicine & Rehabilitation 208100000X
- Surgery, Plastic and Reconstructive Surgery 2086S0122X
- Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X
- Podiatrist 213E00000X · Primary
In this directory
Locations and evidence
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Practice location
ORANGE, CA, 928682862
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.