Organization
CROWN CITY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN B. TYSON M.D. (MIDICAL DIRECTOR)
(626) 798-8792
Entity
Organization
Contact information
Practice address
2661 E WASHINGTON BLVD, PASADENA, CA 91107-1412
(626) 798-4952
(626) 296-1403
Mailing address
2661 E WASHINGTON BLVD, PASADENA, CA 91107-1412
(626) 798-8792
(626) 296-1403
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
CA
Other
Enumeration date
07/14/2005
Last updated
07/28/2014
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