GOOD LIFE MEDICAL GROUP INC. NPI 1316940828

NPI Information

GOOD LIFE MEDICAL GROUP, INC. is a family medicine in Lakewood, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GOOD LIFE MEDICAL GROUP, INC. NPI is 1316940828. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3650 SOUTH ST
STE 204
LAKEWOOD, CA
ZIP 90712-521
Phone: (562) 602-8841
Fax: (562) 602-8843

The provider's authorized official is Peter Hugh .
The authorized official title is C.e.o. and has the following contact phone number (562) 602-8841.

The CLIA number assigned to this NPI record is 05D0999209 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/31/2005 and was last updated on 11/14/2010.

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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