Provider Demographics
NPI:1912729310
Name:CROWNS MEDICAL GROUP
Entity type:Organization
Organization Name:CROWNS MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:AROWORADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-899-9712
Mailing Address - Street 1:9578 ARROW ROUTE SUITE A
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730
Mailing Address - Country:US
Mailing Address - Phone:213-800-3607
Mailing Address - Fax:
Practice Address - Street 1:9578 ARROW ROUTE SUITE A
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730
Practice Address - Country:US
Practice Address - Phone:213-800-3607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care MedicineGroup - Single Specialty