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General NPI Number Information
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NPI Number | 1396347191
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Entity Type | Organization
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Legal Business Name | PRIME CHOICE MEDICAL GROUP APMC
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 325 W 3RD AVE STE 101
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City | ESCONDIDO
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State | CA
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Zip | 92025-4140
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Country | US
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Telephone | 619-513-8566
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Fax | 619-434-0178
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Provider Business Mailing Address
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Address Line | 325 W 3RD AVE STE 101
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City | ESCONDIDO
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State | CA
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Zip | 92025-4140
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Country | US
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Telephone | 619-513-8566
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Fax | 619-434-0178
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Authorized Official
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Title or Position | PROVIDER
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Name | BENJAMIN GROSS
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Credential | MD
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Telephone | 619-513-8566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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