CENTINELA MEDICAL GROUP NPI 1902936099

NPI Information

CENTINELA MEDICAL GROUP is a general practice in Inglewood, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee CENTINELA MEDICAL GROUP NPI is 1902936099. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Parklane Medical Group Inc.

The provider's business location address is:

933 CENTINELA AVE
B
INGLEWOOD, CA
ZIP 90302-501
Phone: (310) 677-5090
Fax: (310) 677-7302

The provider's authorized official is George Chikelue Ifeorah .
The authorized official title is Director and has the following contact phone number (310) 677-5090.

The CLIA number assigned to this NPI record is 05D0937730 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/7/2007 and was last updated on 3/20/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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