Healthcare Provider Details

I. General information

NPI: 1114775012
Provider Name (Legal Business Name): BREEZE MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18012 WIKA RD
APPLE VALLEY CA
92307-2125
US

IV. Provider business mailing address

18092 WIKA RD STE 220
APPLE VALLEY CA
92307-2132
US

V. Phone/Fax

Practice location:
  • Phone: 442-292-2358
  • Fax:
Mailing address:
  • Phone: 760-515-6260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: ARTUR GRIGORIYAN
Title or Position: PRESIDENT
Credential: MD
Phone: 760-515-6260