| Organization Name: | GRAND OB-GYN MEDICAL GROUP INC |
| NPI Number: | 1043571599 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THOMAS TUAN TONG LEE (MEDICAL DIRECTOR) |
| Mailing Address: | 4950 San Bernardino St Sute 106 Montclair |
| State: | CA US |
| Postal Code: | 917632328 |
| Phone Number: | 9096250615 |
| Fax Number: | 9096216735 |
| NPI Enumeration Date: | 05/31/2012 |
| NPI Last Update Date: | 06/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VE0102X |
| License Number: | A37294 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Reproductive Endocrinology |
| Taxonomy Definition: | An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. |