| Magnolia Medical Group, Inc. | |
|
12921 Fern St Ste E Garden Grove CA 92841-4300 | |
| (714) 899-8198 | |
| (714) 899-8598 |
| Full Name | Magnolia Medical Group, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 12921 Fern St Ste E, Garden Grove, California |
| Authorized Official Name and Position | Jeffrey D Chu (PRESIDENT) |
| Authorized Official Contact | 7145346400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Medical Group, Inc. 12921 Fern St Ste E Garden Grove CA 92841-4300 Ph: (714) 899-8198 | Magnolia Medical Group, Inc. 12921 Fern St Ste E Garden Grove CA 92841-4300 Ph: (714) 899-8198 |
| NPI Number | 1275612665 |
|---|---|
| Provider Enumeration Date | 11/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275612665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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