| NPI | 1255639381 |
|---|---|
| Doing Business As | GRANT/RIVERSIDE MEDICAL CARE FOUNDATION, INC |
| Entity Type | Organization |
| Authorized Contact | MARK WUESTEWALD Director Of Revenue Cycle 611-544-6351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 207R00000X Internal Medicine | |
| 207RS0010X Internal Medicine, Sports Medicine | |
| Enumeration Date | 2011-03-15 |
| Last Update Date | 2011-03-15 |