Provider Demographics
NPI:1033426028
Name:GRACE FAMILY HEALTH, INC.
Entity Type:Organization
Organization Name:GRACE FAMILY HEALTH, INC.
Other - Org Name:MURRIETA EXPRESS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LILY
Authorized Official - Middle Name:YUNG
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-231-1385
Mailing Address - Street 1:23811 WASHINGTON AVE
Mailing Address - Street 2:C110-220
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-2267
Mailing Address - Country:US
Mailing Address - Phone:951-231-1385
Mailing Address - Fax:866-686-7693
Practice Address - Street 1:24910 LAS BRISAS RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-4010
Practice Address - Country:US
Practice Address - Phone:951-231-1385
Practice Address - Fax:951-461-9191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-12
Last Update Date:2017-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA066038261QP2300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care