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General NPI Number Information
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NPI Number | 1881764777
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Entity Type | Organization
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Legal Business Name | CROWN MEDICAL GROUP INC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 25470 MEDICAL CENTER DRIVE SUITE 205
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City | MURRIETA
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State | CA
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Zip | 92562
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Country | US
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Telephone | 951-677-0215
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Fax | 951-296-6149
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Provider Business Mailing Address
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Address Line | 25470 MEDICAL CENTER DR SUITE 205
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City | MURRIETA
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State | CA
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Zip | 92562-4900
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Country | US
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Telephone | 951-677-0215
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Fax | 951-677-0991
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FESTUS DADA
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Credential | M.D.
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Telephone | 951-973-7290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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