| Centinela Medical Center Of South Bay Inc. | |
|
1125 Cherry Ave Long Beach CA 90813-3911 | |
| (562) 591-1111 | |
| Not Available |
| Full Name | Centinela Medical Center Of South Bay Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1125 Cherry Ave, Long Beach, California |
| Authorized Official Name and Position | Jerry A. Okonkwoaguolu (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5625911111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centinela Medical Center Of South Bay Inc. Po Box 1405 Lawndale CA 90260-6305 Ph: (562) 591-1111 | Centinela Medical Center Of South Bay Inc. 1125 Cherry Ave Long Beach CA 90813-3911 Ph: (562) 591-1111 |
| NPI Number | 1912219635 |
|---|---|
| Provider Enumeration Date | 07/10/2010 |
| Last Update Date | 03/31/2014 |
| Medicare PECOS PAC ID | 8729219233 |
|---|---|
| Medicare Enrollment ID | O20140326002068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912219635 | NPI | - | NPPES |
| Provider Name | Jerry A Okonkwo Aguolu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134239932 PECOS PAC ID: 6204832819 Enrollment ID: I20070515000220 |
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