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General NPI Number Information
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NPI Number | 1356007819
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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 | 11/09/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 625 E BADILLO ST
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City | COVINA
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State | CA
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Zip | 91723-2800
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Country | US
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Telephone | 626-915-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 625 E BADILLO ST
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City | COVINA
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State | CA
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Zip | 91723-2800
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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 | 626-422-0121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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