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General NPI Number Information
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NPI Number | 1548684012
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Entity Type | Organization
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Legal Business Name | JEFF T. GRANGE, MD
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Dates
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Enumeration Date | 02/05/2014
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 11727 PENDLETON RD
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City | YUCAIPA
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State | CA
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Zip | 92399-9718
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Country | US
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Telephone | 909-790-9950
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Fax |
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Provider Business Mailing Address
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Address Line | 11727 PENDLETON RD
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City | YUCAIPA
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State | CA
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Zip | 92399-9718
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Country | US
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Telephone | 909-790-9950
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFF GRANGE
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Credential |
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Telephone | 909-790-9950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State | CA
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