CENTINELA MEDICAL GROUP NPI 1902215577

NPI Information

NPI: 1902215577
Provider Name: CENTINELA MEDICAL GROUP

Former Legal Business Name: PARKLANE MEDICAL GROUP INC

Classification: General Practice - 208D00000X
Entity Type: Organization

Address:
4405 S MAIN ST
LOS ANGELES, CA
ZIP 90037
Phone: (323) 231-0965
Get Directions

CENTINELA MEDICAL GROUP is a general practice in Los Angeles, CA. CENTINELA MEDICAL GROUP NPI is 1902215577. 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:

4405 S MAIN ST
LOS ANGELES, CA
ZIP 90037-731
Phone: (323) 231-0965
Fax: (323) 231-6512

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 05D2128373 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/8/2014 and was last updated on 8/8/2014.

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		FNP31076	CALIFORNIA	Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W11686	MEDICARE PIN	CALIFORNIA

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »