Provider Demographics
NPI:1063062776
Name:NORTH HILLS MEDICAL OFFICES, INC
Entity type:Organization
Organization Name:NORTH HILLS MEDICAL OFFICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-317-4787
Mailing Address - Street 1:15343 PARTHENIA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-5105
Mailing Address - Country:US
Mailing Address - Phone:424-317-4787
Mailing Address - Fax:818-810-9052
Practice Address - Street 1:15343 PARTHENIA ST
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-5105
Practice Address - Country:US
Practice Address - Phone:424-317-4787
Practice Address - Fax:818-810-9052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-14
Last Update Date:2019-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC51338OtherMEDICAL BOARD OF CALIFORNIA