Organization
CELLESTE MEDICAL, INC.
Active
Organization
CELLESTE MEDICAL, INC.
Active
Other names
GRACE MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
NARY LEE CHENG (CHIEF ADMINISTRATOR)
(213) 604-6879
Entity
Organization
Contact information
Practice address
7800 COMMONWEALTH AVE STE 101, BUENA PARK, CA 90621-2496
(714) 886-8321
Mailing address
7800 COMMONWEALTH AVE STE 101, BUENA PARK, CA 90621-2496
(714) 886-8321
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207VG0400X
Gynecology Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/18/2022
Last updated
01/18/2022
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