Provider Demographics
NPI:1467979179
Name:CROWN MEDICAL HEALTH GROUP INC
Entity Type:Organization
Organization Name:CROWN MEDICAL HEALTH GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VERGINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PILIPOSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-597-0216
Mailing Address - Street 1:2011 W WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4010
Mailing Address - Country:US
Mailing Address - Phone:323-597-0216
Mailing Address - Fax:323-597-0249
Practice Address - Street 1:2011 W WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4010
Practice Address - Country:US
Practice Address - Phone:323-597-0216
Practice Address - Fax:323-597-0249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty