Organization
GREGGORY R. DEVORE M.D. A MEDICAL CORPORATION
Active
Other names
Fetal Diagnostic Center of Pasadena, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGGORY RUSSELL DEVORE M.D. (PRESIDENT)
(626) 583-8911
Entity
Organization
Contact information
Practice address
50 ALESSANDRO PL STE 330, PASADENA, CA 91105-3187
(626) 583-8911
(626) 583-8894
Mailing address
50 ALESSANDRO PL STE 330, PASADENA, CA 91105-3187
(626) 583-8911
(626) 583-8894
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G44446
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G444460
—
CA
05
—
00G444461
—
CA
05
—
1679762702
—
CA
Enumeration date
10/15/2007
Last updated
10/04/2018
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