Organization
CROWN SURGERY MEDICAL GROUP INC
Active
Other names
Crown Surgery Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FETUS DADA M.D. (PRESIDENT)
(951) 973-7290
Entity
Organization
Contact information
Practice address
25470 MEDICAL CENTER DR, SUITE 203, MURRIETA, CA 92562-4900
(951) 973-7290
(951) 973-7299
Mailing address
25470 MEDICAL CENTER DR, SUITE 203, MURRIETA, CA 92562-4900
(951) 973-7290
(951) 973-7299
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
11/06/2006
Last updated
02/17/2020
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