| Southbay Advance Medical Group, Inc. | |
|
15731 S Western Ave Gardena CA 90247-6157 | |
| (310) 808-0199 | |
| Not Available |
| Full Name | Southbay Advance Medical Group, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 15731 S Western Ave, Gardena, California |
| Authorized Official Name and Position | Morris Halfon (DIRECTOR) |
| Authorized Official Contact | 3108080199 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southbay Advance Medical Group, Inc. 15731 S Western Ave Gardena CA 90247-6157 Ph: (310) 808-0199 | Southbay Advance Medical Group, Inc. 15731 S Western Ave Gardena CA 90247-6157 Ph: (310) 808-0199 |
| NPI Number | 1457373383 |
|---|---|
| Provider Enumeration Date | 07/23/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457373383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A27935 (California) | Primary |
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