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South Atlantic Medical Group
General Practice Physician in Gardena, California
NPI 1306029806

South Atlantic Medical Group is a General Practice Physician based in Los Angeles, CA. South Atlantic Medical Group practices in Gardena, CA. The NPI Number for South Atlantic Medical Group is 1306029806 and holds a License No. A41061 (California).

The current practice location address for South Atlantic Medical Group is 1030 W Gardena Blvd, Gardena, CA and can be reached out via phone at 310-323-9999.

Location: 1030 W Gardena Blvd, Gardena, CA, 90022-4104
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1306029806
Provider Name
South Atlantic Medical Group
Credential
Provider Entity Type
Organization
Address
1030 W Gardena Blvd, Gardena, CA, 90022-4104
Phone Number
310-323-9999
Fax Number
Provider Enumeration Date
12/07/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
GR0020634 05 CA
institution
Provider Business Practice Location Address Details
Address
1030 W Gardena Blvd
City
Gardena
State
California
Zip
90247-4956
Phone Number
310-323-9999
Fax Number
person
Provider Business Mailing Address Details
Address
1030 W Gardena Blvd
City
Gardena
State
California
Zip
90247-4956
Phone Number
310-323-9999
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
A41061 (California)
Definition
Definition to come...
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