Organization
DOC1 MEDICAL GROUP PROFESSIONAL CORPORATION
Active
Organization
DOC1 MEDICAL GROUP PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN HARMON (DIRECTOR OF CLINICAL OPERATIONS)
(714) 707-0855
Entity
Organization
Contact information
Practice address
14532 CENTRAL AVE, CHINO, CA 91710-9503
(949) 868-3377
(800) 881-7739
Mailing address
14532 CENTRAL AVE, CHINO, CA 91710-9503
(949) 868-3377
(800) 881-7739
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/02/2021
Last updated
01/26/2022
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