Organization
SAN FERNANDO MISSION MEDICAL GRP
Active
Organization
SAN FERNANDO MISSION MEDICAL GRP
Active
Other names
DBA MISSION MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERLINDA DY GREY M.D. (MEDICAL DIRECTOR)
(818) 782-4325
Entity
Organization
Contact information
Practice address
8215 VAN NUYS BLVD, 210-204, PANORAMA CITY, CA 91402-4810
(818) 782-4325
(818) 782-7320
Mailing address
8215 VAN NUYS BLVD, 210-204, PANORAMA CITY, CA 91402-4810
(818) 782-4325
(818) 782-7320
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
Primary
A30427
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0059210
—
CA
Enumeration date
04/14/2006
Last updated
10/19/2011
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