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Crescent Physician Group

Clinic/Center, Medical Specialty in Los Angeles, CA. Organization (NPI-2).

NPI number1952014698
StatusActive
Last updated in NPPESDec 27, 2022

Details

NPI
1952014698
Entity type
Organization (NPI-2)
Legal business name
Crescent Physician Group
Organization subpart
No
Enumeration date
Dec 27, 2022
Certification date
Dec 27, 2022
Last updated
Dec 27, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM2500X Clinic/Center, Medical Specialty––Yes
261QE0800X Clinic/Center, Endoscopy––

Practice location

2784 Casiano Rd
Los Angeles, CA 90077-1524

Phone 310-409-6559 · Fax 213-745-0152

Mailing address

601 N Crescent Dr
Beverly Hills, CA 90210-3329

Phone 310-409-6559 · Fax 213-745-0152

Authorized official

Michael Yadegari
Ceo
3104096559

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