Addis Medical Group A Medical Corporation | |
23700 Camino Del Sol Torrance CA 90505-5017 | |
(310) 530-1151 | |
(310) 626-9390 |
Full Name | Addis Medical Group A Medical Corporation |
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Speciality | Psychiatry & Neurology |
Location | 23700 Camino Del Sol, Torrance, California |
Authorized Official Name and Position | Hiruy H Gessesse (OWNER) |
Authorized Official Contact | 4244007748 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Addis Medical Group A Medical Corporation Po Box 4570 Palos Verdes Peninsula CA 90274-9607 Ph: (424) 400-7748 | Addis Medical Group A Medical Corporation 23700 Camino Del Sol Torrance CA 90505-5017 Ph: (310) 530-1151 |
NPI Number | 1013289339 |
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Provider Enumeration Date | 02/01/2012 |
Last Update Date | 09/11/2014 |
Medicare PECOS PAC ID | 0941463335 |
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Medicare Enrollment ID | O20120522001225 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013289339 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | A101106 (California) | Primary |
Provider Name | Anna I Lau |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1942240882 PECOS PAC ID: 2961455019 Enrollment ID: I20050301000353 |
Provider Name | Lisa Kahn |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1528008430 PECOS PAC ID: 9739111303 Enrollment ID: I20050902000543 |
Provider Name | Hiruy H Gessesse |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1902091481 PECOS PAC ID: 2062572514 Enrollment ID: I20081113000774 |
Provider Name | Ajmal Mohammad |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700017712 PECOS PAC ID: 2365570504 Enrollment ID: I20100510000669 |
Provider Name | Cordelia Rose E Onyekwe |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194026542 PECOS PAC ID: 2163686577 Enrollment ID: I20120615000265 |
Provider Name | Victoria Omuson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184920050 PECOS PAC ID: 6608030028 Enrollment ID: I20120615000290 |
Provider Name | Bruce A Lyons |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1225040363 PECOS PAC ID: 8022237064 Enrollment ID: I20140924000337 |
Provider Name | Assefa E Mekonnen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942605126 PECOS PAC ID: 4880996016 Enrollment ID: I20160105002949 |
Provider Name | Kesha Saucier |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407254881 PECOS PAC ID: 2769774439 Enrollment ID: I20160718000541 |
Provider Name | Sarah Ko |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336699933 PECOS PAC ID: 0042590812 Enrollment ID: I20161213002553 |
Provider Name | Sonnia Aba Ahinasi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952792467 PECOS PAC ID: 3375823941 Enrollment ID: I20161219000349 |
Provider Name | Irine Niuke Achuamang |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760999114 PECOS PAC ID: 1759643786 Enrollment ID: I20180402002174 |
Provider Name | Picolya Katice Robinson |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1699977934 PECOS PAC ID: 1456693589 Enrollment ID: I20190422000298 |
Provider Name | Helen F Ntung |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992219661 PECOS PAC ID: 6406181411 Enrollment ID: I20190712002652 |
Provider Name | Eunice Lee |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093272338 PECOS PAC ID: 6709219421 Enrollment ID: I20200115001477 |
Provider Name | Chukwudi Obue |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477189223 PECOS PAC ID: 6507271038 Enrollment ID: I20210216001242 |
Provider Name | Esther U Okafor |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104073865 PECOS PAC ID: 5991193369 Enrollment ID: I20211104001181 |
Provider Name | Richard Angelo Monforte |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487303475 PECOS PAC ID: 5799154183 Enrollment ID: I20221206003270 |
Provider Name | Felix Erhiorhi Umukoro |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275286601 PECOS PAC ID: 6305215369 Enrollment ID: I20221214000120 |
Provider Name | Charilyn Bringas |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659715266 PECOS PAC ID: 7911181144 Enrollment ID: I20230703002007 |
Provider Name | Fun Wing Wong |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972205144 PECOS PAC ID: 6800259318 Enrollment ID: I20230831001934 |
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