# GRACE MOBILE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447046883
- **Authorized official:** MR. ROLAND T FLORES RN (CEO)
- **Authorized official phone:** (310) 245-1414

## Contact information

- **Practice address:** 17315 STUDEBAKER RD STE 204, CERRITOS, CA 90703-2508
- **Practice address phone:** (310) 295-6492
- **Practice address fax:** (310) 295-6542
- **Mailing address:** 17315 STUDEBAKER RD STE 204, CERRITOS, CA 90703-2508
- **Mailing address phone:** (310) 295-6492
- **Mailing address fax:** (310) 295-6542

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/15/2025
- **Last updated:** 04/15/2025