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General NPI Number Information
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NPI Number | 1699653808
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Entity Type | Organization
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Legal Business Name | BLESSED HANDS MEDICAL GROUP
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 980 W 6TH ST STE 213
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City | ONTARIO
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State | CA
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Zip | 91762-1235
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Country | US
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Telephone | 404-259-8361
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Fax |
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Provider Business Mailing Address
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Address Line | 980 W 6TH ST STE 213
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City | ONTARIO
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State | CA
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Zip | 91762-1235
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Country | US
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Telephone | 404-259-8361
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOYCELYN GARDNER
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Credential | APRN
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Telephone | 404-259-8361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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