| Grace Family Medical Clinic | |
|
18331 Gridley Rd Suite A Cerritos CA 90703-5438 | |
| (562) 865-3738 | |
| Not Available |
| Full Name | Grace Family Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 18331 Gridley Rd, Cerritos, California |
| Authorized Official Name and Position | John Ehum (PRESIDENT) |
| Authorized Official Contact | 5628653738 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Family Medical Clinic 18331 Gridley Rd Suite A Cerritos CA 90703-5438 Ph: (562) 865-3738 | Grace Family Medical Clinic 18331 Gridley Rd Suite A Cerritos CA 90703-5438 Ph: (562) 865-3738 |
| NPI Number | 1215472048 |
|---|---|
| Provider Enumeration Date | 01/03/2017 |
| Last Update Date | 01/03/2017 |
| Medicare PECOS PAC ID | 3173805827 |
|---|---|
| Medicare Enrollment ID | O20170113000207 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215472048 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A97838 (California) | Primary |
| Provider Name | John J Ehum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942483409 PECOS PAC ID: 5597047506 Enrollment ID: I20170228001952 |
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