| Grand Medical Group Ob/gyn Inc | |
|
4950 San Bernardino St Ste. 106 Montclair CA 91763-2328 | |
| (909) 625-9063 | |
| (909) 621-1255 |
| Full Name | Grand Medical Group Ob/gyn Inc |
|---|---|
| Speciality | Obstetrics & Gynecology |
| Location | 4950 San Bernardino St, Montclair, California |
| Authorized Official Name and Position | Thomas T. Lee (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9096259063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Medical Group Ob/gyn Inc 4950 San Bernardino St Ste. 106 Montclair CA 91763-2328 Ph: (909) 625-9063 | Grand Medical Group Ob/gyn Inc 4950 San Bernardino St Ste. 106 Montclair CA 91763-2328 Ph: (909) 625-9063 |
| NPI Number | 1477763829 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 04/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477763829 | NPI | - | NPPES |
| GR0051990 | Medicaid | CA |
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