Organization Name: | MOUNTAIN GROUP LLC |
NPI Number: | 1144665100 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EARL SAI YOUNG (GENERAL PARTNER) |
Mailing Address: | 931 Buena Vista St Suite 103 Duarte |
State: | CA US |
Postal Code: | 910101712 |
Phone Number: | 6265316891 |
Fax Number: | 6265316890 |
NPI Enumeration Date: | 05/05/2013 |
NPI Last Update Date: | 04/01/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Sleep Disorder Diagnostic |
Taxonomy Definition: |