| Crown City Medical Group Inc | |
|
6601 Rugby Ave # 300 Huntington Park CA 90255-4040 | |
| (323) 582-1177 | |
| (323) 589-2635 |
| Full Name | Crown City Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 6601 Rugby Ave, Huntington Park, California |
| Authorized Official Name and Position | Maureen Tyson (CEO) |
| Authorized Official Contact | 6267988792 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crown City Medical Group Inc 6601 Rugby Ave # 300 Huntington Park CA 90255-4040 Ph: (323) 582-1177 | Crown City Medical Group Inc 6601 Rugby Ave # 300 Huntington Park CA 90255-4040 Ph: (323) 582-1177 |
| NPI Number | 1508989500 |
|---|---|
| Provider Enumeration Date | 04/06/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508989500 | NPI | - | NPPES |
| GR0041811 | Other | CA | MEDI-CAL PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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