| Southern California Medical Gastroenterology Group, Inc. | |
|
1301 20th St 280 Santa Monica CA 90404-2050 | |
| (310) 829-6789 | |
| (310) 315-0204 |
| Full Name | Southern California Medical Gastroenterology Group, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1301 20th St, Santa Monica, California |
| Authorized Official Name and Position | Thomas L Kun (PRESIDENT) |
| Authorized Official Contact | 3108290045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern California Medical Gastroenterology Group, Inc. 1301 20th St 280 Santa Monica CA 90404-2050 Ph: (310) 829-6789 | Southern California Medical Gastroenterology Group, Inc. 1301 20th St 280 Santa Monica CA 90404-2050 Ph: (310) 829-6789 |
| NPI Number | 1467536409 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 05/22/2015 |
| Medicare PECOS PAC ID | 3173584273 |
|---|---|
| Medicare Enrollment ID | O20041021001061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467536409 | NPI | - | NPPES |
| ZZZ74015Z | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Marc H Harwitt |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1285613943 PECOS PAC ID: 3072531979 Enrollment ID: I20051109000723 |
| Provider Name | David W Rogers |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073560389 PECOS PAC ID: 8820095839 Enrollment ID: I20061106000381 |
| Provider Name | Lenna A Martyak |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1164638177 PECOS PAC ID: 6800965385 Enrollment ID: I20080523000423 |
| Provider Name | Thomas Kun |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508841321 PECOS PAC ID: 1850489766 Enrollment ID: I20101215000622 |
| Provider Name | Rudolph A Bedford |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1902885684 PECOS PAC ID: 7113015025 Enrollment ID: I20101228000187 |
| Provider Name | Richard Corlin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649259268 PECOS PAC ID: 8123116035 Enrollment ID: I20101228000224 |
| Provider Name | Kamyar Shahedi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780818823 PECOS PAC ID: 4284897323 Enrollment ID: I20120529000498 |
| Provider Name | Rahul Dixit |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508073057 PECOS PAC ID: 4587834619 Enrollment ID: I20130909000803 |
| Provider Name | James H Sul |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346260346 PECOS PAC ID: 4587767546 Enrollment ID: I20150812007239 |
Vitality&longevity Medical Center A Professional Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2221 Lincoln Blvd, Suite 200, Santa Monica, CA 90405 Phone: 310-581-8585 Fax: 320-215-4650 | |
Cynthia Kodama, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2104 Wilshire Blvd, Santa Monica, CA 90403 Phone: 310-882-8258 | |
Premier Medical Group. Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2336 Santa Monica Blvd, Suite 304, Santa Monica, CA 90404 Phone: 310-420-9191 | |
Santa Monica Bay Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 Santa Monica Blvd, 1070, Santa Monica, CA 90404 Phone: 310-315-7900 Fax: 310-315-7931 | |
Santa Monica Bay Physicinas Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1260 15th St, 1501, Santa Monica, CA 90404 Phone: 310-656-1700 Fax: 310-458-1061 | |
Jimmy C. Huang, D.o. A Professional Corp. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2210 Santa Monica Blvd., Suite C, Santa Monica, CA 90404 Phone: 310-828-1708 Fax: 310-828-1705 | |
Joseph J Pinzone M D Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2001 Santa Monica Blvd Ste 1190w, Santa Monica, CA 90404 Phone: 888-580-5900 Fax: 855-510-0119 |