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General NPI Number Information
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NPI Number | 1295474260
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Entity Type | Organization
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Legal Business Name | GRANDVIEW MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 05/30/2022
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Last Update Date | 05/30/2022
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Provider Practice Location Address
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Address Line | 315 N 3RD AVE STE 200
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City | COVINA
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State | CA
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Zip | 91723-1915
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Country | US
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Telephone | 626-967-3176
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Fax |
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Provider Business Mailing Address
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Address Line | 1114 HIGHLIGHT DR
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City | WEST COVINA
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State | CA
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Zip | 91791-3492
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Country | US
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Telephone | 626-422-0121
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Fax |
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Authorized Official
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Title or Position | BOARD MEMBER
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Name | MARITESS YEE
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Credential | RN
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Telephone | 626-967-3176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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