| NPI | 1003148081 |
|---|---|
| Doing Business As | GRANITE CREEK FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JENNIFER ROSE BOOZER President 909-450-1571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA 2OA8927) |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2010-02-02 |