Great Spirit Medical Group,inc

NPI 1407869928 - Family Medicine - 207Q00000X

NPI Details
NPI 1407869928
Enumeration Date 08/14/2006
Last Updated 11/12/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name CONRADO J.R CONRADO
Position MEDICAL DIRECTOR
Phone (818) 701-0017
Fax (818) 701-0073
Practice Location
9900 BALBOA BLVD
SUITE A
NORTHRIDGE CA, 91325-5403, US
Phone (818) 701-0017
Fax (818) 701-0073
Business Location
9900 BALBOA BLVD
SUITE A
NORTHRIDGE CA, 91325-5403, US
Phone (818) 701-0017
Fax (818) 701-0073
Toxanomy
Taxonomy Code 207Q00000X
License State California
License Number A48817
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According to our database, Great Spirit Medical Group,inc NPI is 1407869928, taxonomy code is 207Q00000X and license number is A48817, license state is located at California. Great Spirit Medical Group,inc physically located at 9900 Balboa Blvd, Northridge CA, 91325-5403. NPI Number 1033115704 has the healthcare provider type.

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1407869928 NPI number is provided on an as is basis without warranty of any kind. 1407869928 is maintained by the National Plan & Provider Enumeration System. The contents of Great Spirit Medical Group,inc are for informational purposes only.