Healthcare Provider Details

I. General information

NPI: 1740823632
Provider Name (Legal Business Name): GRACE FAMILY HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2019
Last Update Date: 10/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24910 LAS BRISAS RD STE 116
MURRIETA CA
92562-4035
US

IV. Provider business mailing address

24910 LAS BRISAS RD STE 116
MURRIETA CA
92562-4035
US

V. Phone/Fax

Practice location:
  • Phone: 951-231-1385
  • Fax: 951-461-9191
Mailing address:
  • Phone: 951-231-1385
  • Fax: 951-461-9191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. LILY Y. PHILLIPS
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 951-231-1385