MEDICARE: BLESSED HANDS MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1699653808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLESSED HANDS MEDICAL GROUP

Provider Business Mailing Address
First Line	:	980 W 6TH ST STE 213
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-1235
Country	:	US
Telephone Number	:	404-259-8361
Fax Number	:

Provider Business Practice Location Address
First Line	:	980 W 6TH ST STE 213
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91762-1235
Country	:	US
Telephone Number	:	404-259-8361
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOYCELYN GARDNER
Credential	:	APRN
Telephone Number	:	404-259-8361

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/25/2025

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Directions to “BLESSED HANDS MEDICAL GROUP ” Practice Location

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