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General NPI Number Information
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NPI Number | 1952497513
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Entity Type | Organization
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Legal Business Name | YOLANDA T GRADY, M.D. INC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 05/29/2012
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Provider Practice Location Address
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Address Line | 13768 ROSWELL AVE SUITE 202
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City | CHINO
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State | CA
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Zip | 91710-1401
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Country | US
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Telephone | 909-628-4205
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Fax | 909-628-4875
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Provider Business Mailing Address
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Address Line | 13768 ROSWELL AVE SUITE 202
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City | CHINO
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State | CA
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Zip | 91710-1401
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Country | US
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Telephone | 909-628-4205
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Fax | 909-628-4875
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YOLANDA GRADY
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Credential | M.D.
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Telephone | 909-628-4205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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