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NPI Profile for GRAND OB GYN MEDICAL GROUP INC in MONTCLAIR, CA.
An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Gynecologic Oncology |
207VX0201X | 16 | Physician/Obstetrics & Gynecology | |
Maternal & Fetal Medicine |
207VM0101X | 16 | Physician/Obstetrics & Gynecology | |
Reproductive Endocrinology |
207VE0102X | 16 | Physician/Obstetrics & Gynecology | |
Surgery |
208600000X | 02 | Physician/General Surgery |
| NPI # | 1043571599 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 05/31/2012 | |
| Last updated | 06/01/2012 - About 14 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
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|
| Hospital affiliation(s) | Not Available |
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GRAND OB-GYN MEDICAL GROUP INC
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GRAND OB-GYN MEDICAL GROUP INC