Green Peace Medical Group | |
330 W Las Tunas Dr Suite 3 San Gabriel CA 91776-1213 | |
(626) 573-0055 | |
(626) 573-4087 |
Full Name | Green Peace Medical Group |
---|---|
Speciality | Family Medicine |
Location | 330 W Las Tunas Dr, San Gabriel, California |
Authorized Official Name and Position | Sheng H Chang (OWNER) |
Authorized Official Contact | 6265730055 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Green Peace Medical Group 330 W Las Tunas Dr Suite 3 San Gabriel CA 91776-1213 Ph: (626) 573-0055 | Green Peace Medical Group 330 W Las Tunas Dr Suite 3 San Gabriel CA 91776-1213 Ph: (626) 573-0055 |
NPI Number | 1003801648 |
---|---|
Provider Enumeration Date | 09/20/2005 |
Last Update Date | 06/16/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003801648 | NPI | - | NPPES |
GR0091430 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | A33409 (California) | Primary |
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