Organization Active NPI

Grace Medical Group of the Valley Inc

  • Family Medicine Physician
  • Pomona, CA
National Provider Identifier
1215965223
Registry record updated Jun 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GRACE MEDICAL GROUP OF THE VALLEY INC
Practice address
2740 N Garey Ave
Suite 100
Pomona, CA 91767-1800
Phone
(909) 392-3230
Fax
(909) 392-3224
NPI assigned
Jun 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2017

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

Authorized official

Name
Dr. Craig Endo, M.D.
Title
Ceo
Phone
(909) 392-3230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2740 N Garey Ave
Suite 100
Pomona, CA 91767-1800

Mailing address

PO Box 1628
Claremont, CA 91711
Phone (909) 392-3230

National Provider Directory

National Provider Directory

Locations

2740 N Garey Ave
Pomona, CA 91767
Phone (909) 623-2300

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498521600000",
    "number": "1215965223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1628",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "91711",
            "telephone_number": "909-392-3230",
            "fax_number": "909-392-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 N GAREY AVE",
            "address_2": "SUITE 100",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917671800",
            "telephone_number": "909-392-3230",
            "fax_number": "909-392-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE MEDICAL GROUP OF THE VALLEY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2017-06-27",
        "status": "A",
        "authorized_official_last_name": "ENDO",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-392-3230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.