| South Cerritos Medical Group, Inc. | |
|
20927 Norwalk Blvd Lakewood CA 90715-1545 | |
| (562) 809-1434 | |
| (562) 809-1526 |
| Full Name | South Cerritos Medical Group, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 20927 Norwalk Blvd, Lakewood, California |
| Authorized Official Name and Position | Conchita Yatar Goings (PHYSICIAN) |
| Authorized Official Contact | 5628091434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Cerritos Medical Group, Inc. 13381 Silver Berry Cir Cerritos CA 90703-1374 Ph: (562) 809-1434 | South Cerritos Medical Group, Inc. 20927 Norwalk Blvd Lakewood CA 90715-1545 Ph: (562) 809-1434 |
| NPI Number | 1952526675 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952526675 | NPI | - | NPPES |
| A41071 | Other | CA | STATE LICENSE |
| W13073 | Other | CA | GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | A41071 (California) | Primary |
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