Organization
CROWN CITY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAUREEN B TYSON (CHIEF EXECUTIVE OFFICER)
(626) 798-8792
Entity
Organization
Contact information
Practice address
1800 N WESTERN AVE, SUITE 403, SAN BERNARDINO, CA 92411
(909) 887-3087
(909) 887-2974
Mailing address
2589 E WASHINGTON BLVD, PASADENA, CA 91107-1446
(626) 798-8792
(626) 296-1403
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
08/05/2013
Last updated
08/05/2013
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