CENTINELA MEDICAL GROUP NPI 1043654676

NPI Information

NPI: 1043654676
Provider Name: CENTINELA MEDICAL GROUP

Former Legal Business Name: PARKLANE MEDICAL GROUP INC

Classification: General Practice - 208D00000X
Entity Type: Organization

Address:
12900 AVALON BLVD
LOS ANGELES, CA
ZIP 90061
Phone: (310) 538-5222
Get Directions

CENTINELA MEDICAL GROUP is a general practice in Los Angeles, CA. CENTINELA MEDICAL GROUP NPI is 1043654676. 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:

12900 AVALON BLVD
LOS ANGELES, CA
ZIP 90061-734
Phone: (310) 538-5222
Fax: (310) 532-7888

The provider's authorized official is George Chike Ifeorah .
The authorized official title is Director and has the following contact phone number (310) 367-3107.

The CLIA number assigned to this NPI record is 05D0864748 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/25/2013 and was last updated on 4/25/2013.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		FNP 31076	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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