| 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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