NPI | 1134421712 |
---|---|
Doing Business As | CANYON GATE MEDICAL GROUP |
Entity Type | Organization |
Authorized Contact | VERONICA COLON Credentialing Coordinator 954-656-8855 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 936) |
Enumeration Date | 2010-12-02 |
Last Update Date | 2010-12-02 |