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General NPI Number Information
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NPI Number | 1952707689
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Entity Type | Organization
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Legal Business Name | VERNON MEDICAL GROUP INC
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Dates
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Enumeration Date | 11/06/2014
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Last Update Date | 11/06/2014
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Provider Practice Location Address
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Address Line | 231 W VERNON AVE STE 112
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City | LOS ANGELES
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State | CA
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Zip | 90037-2778
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Country | US
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Telephone | 323-234-1468
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Fax | 323-234-1383
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Provider Business Mailing Address
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Address Line | 231 W VERNON AVE STE 112
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City | LOS ANGELES
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State | CA
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Zip | 90037-2778
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Country | US
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Telephone | 323-234-1468
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Fax | 323-234-1383
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Authorized Official
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Title or Position | BILLING DEPT MANAGER
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Name | MISS CHRISTINE M GROVES
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Credential |
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Telephone | 323-234-1468
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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 | G34954
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License Number State | CA
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