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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