Organization
BOSTON MEDICAL GROUP CALIFORNIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN SIMPSON (DIRECTOR OF CQRM)
(615) 562-4578
Entity
Organization
Contact information
Practice address
207 S SANTA ANITA AVE, P25A, SAN GABRIEL, CA 91776
(615) 562-4578
(423) 949-3992
Mailing address
23275 S POINTE DRIVE, SUITE 100, LAGUNA HILLS, CA 92653
(615) 562-4578
(423) 949-3992
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G9455
CA
Other
Enumeration date
12/19/2014
Last updated
12/19/2014
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