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Organization
YOUR MEDICAL GROUP, INC
Active
Organization
YOUR MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAY KUSUMOTO (CEO-PRESIDENT)
(831) 531-4213
Entity
Organization
Contact information
Practice address
591 MCCRAY ST, SUITE 211, HOLLISTER, CA 95023-2224
(831) 531-4213
Mailing address
591 MCCRAY ST, SUITE 211, HOLLISTER, CA 95023-2224
(831) 531-4213
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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