Organization
GROSSMONT OB/GYN MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GERI THOMAS (OFFICE MANAGER)
(619) 461-2663
Entity
Organization
Contact information
Practice address
8851 CENTER DR, STE #500, LA MESA, CA 91942-3017
(619) 461-2660
(619) 461-5760
Mailing address
8851 CENTER DR, STE #500, LA MESA, CA 91942-3017
(619) 461-2660
(619) 461-5760
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C086184
CHAMPUS GROUP I.D.
CA
01
—
ZZZ47807Z
MEDI-CAL
CA
Enumeration date
08/21/2006
Last updated
07/21/2022
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