| NPI | 1447729272 |
|---|---|
| Doing Business As | DIVINE GRACE MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | MARY EPPIE PORCIUNCULA GONZALES CEO 562-474-1605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2018-11-22 |
| Last Update Date | 2020-06-01 |