Organization
NEONATOLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VELLORE GANESH MURALIGOPAL MD (PRESIDENT)
(909) 790-5071
Entity
Organization
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-6380
(909) 580-6361
Mailing address
PO BOX 8188, REDLANDS, CA 92375-1388
(909) 790-5071
(909) 790-5774
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0004460
—
CA
Enumeration date
08/16/2006
Last updated
08/22/2020
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