| South Bay Gastroenterology Medical Group | |
|
23456 Hawthorne Blvd Ste 300 Torrance CA 90505-4716 | |
| (310) 539-2055 | |
| (310) 539-0199 |
| Full Name | South Bay Gastroenterology Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 23456 Hawthorne Blvd Ste 300, Torrance, California |
| Authorized Official Name and Position | Oren Zaidel (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3105392055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Bay Gastroenterology Medical Group 23456 Hawthorne Blvd Ste 300 Torrance CA 90505-4716 Ph: (310) 539-2055 | South Bay Gastroenterology Medical Group 23456 Hawthorne Blvd Ste 300 Torrance CA 90505-4716 Ph: (310) 539-2055 |
| NPI Number | 1609893619 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 09/11/2023 |
| Medicare PECOS PAC ID | 4183651375 |
|---|---|
| Medicare Enrollment ID | O20050719001139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609893619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Jerome D Cohen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922036474 PECOS PAC ID: 3072414507 Enrollment ID: I20040117000144 |
| Provider Name | Oren Zaidel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1689602195 PECOS PAC ID: 2567429376 Enrollment ID: I20041214000205 |
| Provider Name | Gloria M Sze |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1528004090 PECOS PAC ID: 3173539327 Enrollment ID: I20060227000264 |
| Provider Name | Daniel D Cho |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346433828 PECOS PAC ID: 6002975406 Enrollment ID: I20081029000909 |
| Provider Name | Tonny M Lee |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1639118748 PECOS PAC ID: 1759437015 Enrollment ID: I20090929000147 |
| Provider Name | Melissa A Munsell |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134276272 PECOS PAC ID: 4688711674 Enrollment ID: I20091023000326 |
| Provider Name | Minh Q Nguyen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922254432 PECOS PAC ID: 2163554478 Enrollment ID: I20100722000554 |
| Provider Name | Mary Ahmadian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952812448 PECOS PAC ID: 0345508719 Enrollment ID: I20171213002179 |
| Provider Name | Liam Yi Heng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316331838 PECOS PAC ID: 3173888005 Enrollment ID: I20180524002121 |
| Provider Name | Alexander Le Nguyen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1427476233 PECOS PAC ID: 1658643390 Enrollment ID: I20200507001399 |
| Provider Name | Jung H Li |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720501240 PECOS PAC ID: 7214338102 Enrollment ID: I20210629003495 |
| Provider Name | Ronaldo C Mamaril |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013301266 PECOS PAC ID: 7012315211 Enrollment ID: I20211001000842 |
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