| Centinela Medical Group | |
|
933 Centinela Ave B Inglewood CA 90302-1501 | |
| (310) 677-5090 | |
| (310) 677-7302 |
| Full Name | Centinela Medical Group |
|---|---|
| Speciality | General Practice |
| Location | 933 Centinela Ave, Inglewood, California |
| Authorized Official Name and Position | George Chikelue Ifeorah (DIRECTOR) |
| Authorized Official Contact | 3106775090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centinela Medical Group 933 Centinela Ave B Inglewood CA 90302-1501 Ph: (310) 677-5090 | Centinela Medical Group 933 Centinela Ave B Inglewood CA 90302-1501 Ph: (310) 677-5090 |
| NPI Number | 1902936099 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 03/20/2013 |
| Medicare PECOS PAC ID | 5193769099 |
|---|---|
| Medicare Enrollment ID | O20050613000172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902936099 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Hazel Mckillop |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396766994 PECOS PAC ID: 5294799201 Enrollment ID: I20050413000510 |
| Provider Name | Anita W Hibler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306062476 PECOS PAC ID: 8123266574 Enrollment ID: I20130524000580 |
| Provider Name | Nkorrye Ezeobah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689706699 PECOS PAC ID: 2365704251 Enrollment ID: I20180312001779 |
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