Organization
MISSION GROVE MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN LACOMBE (AO)
(951) 780-3300
Entity
Organization
Contact information
Practice address
191 E. ALESSANDRO BLVD #9A, RIVERSIDE, CA 92508-5095
(951) 780-3300
Mailing address
191 E ALESSANDRO BLVD # 9A, RIVERSIDE, CA 92508-5095
(951) 780-3300
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
A39116
CA
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/23/2014
Last updated
03/20/2025
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