Provider Demographics
NPI:1811224298
Name:GROVE INTERNAL MEDICINE INC.
Entity Type:Organization
Organization Name:GROVE INTERNAL MEDICINE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-981-6644
Mailing Address - Street 1:8283 GROVE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3140
Mailing Address - Country:US
Mailing Address - Phone:909-981-6644
Mailing Address - Fax:909-981-5048
Practice Address - Street 1:8283 GROVE AVE STE 201
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3140
Practice Address - Country:US
Practice Address - Phone:909-981-6644
Practice Address - Fax:909-981-5048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty