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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