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General NPI Number Information
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NPI Number | 1013567320
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Entity Type | Organization
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Legal Business Name | PARADISE VALLEY MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 09/18/2019
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 502 EUCLID AVE STE 103
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City | NATIONAL CITY
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State | CA
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Zip | 91950-2982
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Country | US
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Telephone | 619-470-4357
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Fax |
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Provider Business Mailing Address
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Address Line | 655 EUCLID AVE STE 408
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City | NATIONAL CITY
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State | CA
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Zip | 91950-2980
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Country | US
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Telephone | 619-470-4280
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Fax |
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Authorized Official
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Title or Position | MANAGING ASSOCIATE GENERAL COUNSEL
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Name | CHRISTOPHER DOAN
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Credential |
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Telephone | 310-259-4706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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