Mountain Grace Home Fusion LLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

MOUNTAIN GRACE HOME FUSION LLC

Practice address

3868 W Carson St Ste 110
Torrance, CA 90503-6706

Phone

(714) 726-2808

NPI assigned

Nov 5, 2026

Last updated

Nov 5, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Geta Miclaus

Title

Cfo

Phone

(714) 726-2808

Specialties & licenses 9

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1793836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793836800000",
    "number": "1215836093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3868 W CARSON ST STE 110",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3868 W CARSON ST STE 110",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905036706",
            "telephone_number": "714-726-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN GRACE HOME FUSION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-11-05",
        "last_updated": "2026-11-05",
        "certification_date": "2026-11-05",
        "status": "A",
        "authorized_official_last_name": "MICLAUS",
        "authorized_official_first_name": "GETA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "714-726-2808"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Mota E Silva
• Aleksandr Motchenko
• Nour-Lynn Mouallem
• Erin Moulton, BCBA
• Mary Moulton, MA, LMFT
• Pamela Mousseau
• Aram Mouzeyan, M.D., M.A.
• Alireza Movassaghi, D.D.S.
• Movement Horizons Physical Therapy Inc.
• Faith Reiko Moy, OTR/L

• Geriatric Medicine (Family Medicine) Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Geriatric Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.