# COMMUNITY MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grand Valley Primary Care II
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134766421
- **Authorized official:** CHRISTIAN THOMAS (PRESIDENT/CEO)
- **Authorized official phone:** (970) 644-3011

## Contact information

- **Practice address:** 2020 N 12TH ST, GRAND JCT, CO 81501-2914
- **Practice address phone:** (970) 644-4220
- **Practice address fax:** (970) 263-4239
- **Mailing address:** PO BOX 1727, GRAND JUNCTION, CO 81502-1727
- **Mailing address phone:** (970) 256-6322
- **Mailing address fax:** (970) 256-6322

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/05/2019
- **Last updated:** 04/24/2020