# G MARCUS FORD MD

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

## Provider details

- **NPI number:** 1629663455
- **Authorized official:** GLENN FORD MD (OWNER)
- **Authorized official phone:** (323) 439-4811

## Contact information

- **Practice address:** 12258 PERRIS BLVD, MORENO VALLEY, CA 92557-7418
- **Practice address phone:** (909) 964-9524
- **Practice address fax:** (888) 408-1572
- **Mailing address:** 15280 ZAHARIAS ST, MORENO VALLEY, CA 92555-6408
- **Mailing address phone:** (909) 964-9524
- **Mailing address fax:** (888) 408-1572

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/03/2021
- **Last updated:** 03/03/2021