Organization
GROSSMONT UNION HIGH SCHOOL DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY RYAN (SUPERINTENDENT)
(619) 644-8000
Entity
Organization
Contact information
Practice address
1100 MURRAY DR, LA MESA, CA 91944-1043
(619) 644-8000
Mailing address
2777 DEL MONTE ST, WEST SACRAMENTO, CA 95691-3811
(916) 375-1707
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37-68130
MEDI-CAL
CA
Enumeration date
01/08/2007
Last updated
08/22/2020
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