Organization
CITY MEDICAL GROUP INC
Active
Parent organization
CITY MEDICAL GROW INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CITY MEDICAL GROW INC
Authorized official
FRED ONOH (OFFICE MANAGER)
(323) 531-0915
Entity
Organization
Contact information
Practice address
1508 FLORENCE AVENUE, LOS ANGELES, CA 90009
(323) 531-0915
Mailing address
PO BOX 881916, LOS ANGELES, CA 90009
(323) 531-0915
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
NP14622
CA
207V00000X
Obstetrics & Gynecology Physician
A118311
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A118311
—
CA
Enumeration date
08/30/2016
Last updated
08/30/2016
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