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Organization
GROSSMONT MEDICAL CLINIC A PROFESSIONAL CORPORATION
Active
Organization
GROSSMONT MEDICAL CLINIC A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R WEBB M.D. (PRESIDENT)
(619) 589-8626
Entity
Organization
Contact information
Practice address
8851 CENTER DR, SUITE 408, LA MESA, CA 91942-3017
(619) 589-8626
(619) 589-8864
Mailing address
PO BOX 261699, SAN DIEGO, CA 92196-1699
(619) 589-8626
(619) 589-8864
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0053450
—
CA
01
—
ZZZ34565Z
BLUE SHIELD
—
Enumeration date
09/25/2006
Last updated
06/21/2018
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