Provider Demographics
NPI:1972076644
Name:NEW HOPE MEDICAL GROUP, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:NEW HOPE MEDICAL GROUP, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:951-202-9083
Mailing Address - Street 1:760 WASHBURN AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3303
Mailing Address - Country:US
Mailing Address - Phone:951-268-6995
Mailing Address - Fax:951-268-6559
Practice Address - Street 1:760 WASHBURN AVE STE 6
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3303
Practice Address - Country:US
Practice Address - Phone:951-268-6995
Practice Address - Fax:951-268-6559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-06
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center