PARKLANE MEDICAL GROUP (NPI# 1134335128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134335128 |
| Entity Type | Organization |
| Organization Name | PARKLANE MEDICAL GROUP |
| Other Organization Name | CENTINELA MEDICAL GROUP |
| Practice Address |
12900 South Avalon Bl. Los Angeles CA 90061 |
| Practice Telephone | 3105385222 |
| Practice Fax Number | 3105327888 |
| Mailing Telephone | 3105385222 |
| Mailing Fax Number | 3105327888 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GEORGE C IFEORAH (DIRECTOR) |
| Authorized Official Telephone | 3105385222 |
| Authorized Official Credential | LAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0102062 | 05 |
| Other Name | Type Code |
|---|---|
| CENTINELA MEDICAL GROUP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336355320 | Parklane Medical Group | General Practice | 508 North Long Beach Bl., Compton, CA 90221 | 2007-05-15 |
| 1164588141 | Parklane Medical Group | Family Medicine | 933 Centinela Ave, B, Inglewood, CA 90302-1501 | 2006-12-28 |
| Street Address |
12900 SOUTH AVALON BL. |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90061 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447882782 | Golden State Recuperative Care, Inc. | Lodging | 153 E. 110th St, Los Angeles, CA 90061 | 2020-02-05 |
| 1235695974 | Phyllis Kirby Tisdale | Nurse Practitioner | 145 E 124th Street, Los Angeles, CA 90061 | 2019-02-19 |
| 1003160003 | Alicia Vera | Counselor | 245 E 120th Street, Los Angeles, CA 90061 | 2012-10-30 |
| 1194044974 | Helping Kids To Recover, Inc. | Substance Abuse Rehabilitation Facility | 12628 Avalon Boulevard, Los Angeles, CA 90061 | 2010-05-19 |
| 1124202817 | David Anthony Martinez | Counselor | 11900 S. Avalon Blvd, 1, Los Angeles, CA 90061 | 2007-12-18 |
| 1255538690 | Ceed Security Services Inc | Durable Medical Equipment & Medical Supplies | 12815 South Avalon Blvd, Los Angeles, CA 90061 | 2007-06-29 |
| 1598892184 | Jose Rodriguez | Counselor | 11900 S. Avalon Blvd., Suite 200, Los Angeles, CA 90061 | 2007-02-28 |
| 1316182975 | Luis Rabago | Counselor | 11900 Avalon Blvd, Suite 200, Los Angeles, CA 90061 | 2008-12-11 |
| 1619169406 | Emmanuel A Ayodele | General Practice | 11126 S Main St, Los Angeles, CA 90061 | 2007-08-15 |
| 1003033556 | Khashayar Khodadadi Dds Inc | Dentist | 11900 S. Avalon Blvd., Suite 101, Los Angeles, CA 90061 | 2007-04-19 |
| Find all providers in zip 90061 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063923 | Claude Kathy Marquis | Family Medicine | 400 S June St, Los Angeles, CA 90020-4812 | 2020-11-03 |
| 1376159939 | Margarette Morney-kuanyawo | Family Medicine | 515 S Fuller Ave, Los Angeles, CA 90036-3244 | 2020-09-18 |
| 1780207803 | Julia Solis | Family Medicine | 1414 S Grand Ave Ste 200&380, Los Angeles, CA 90015-3067 | 2020-05-22 |
| 1033739578 | Now Medical | Family Medicine | 1333 S Hill St, Los Angeles, CA 90015-3012 | 2020-04-24 |
| 1710514930 | Los Angeles Medical Center Foundation | Family Medicine | 2010 Wilshire Blvd Fl 2, Los Angeles, CA 90057-3507 | 2020-03-26 |
| 1740817212 | Quality Medical Group Inc | Family Medicine | 5230 Pacific Concourse Dr Ste 110, Los Angeles, CA 90045-6258 | 2020-03-25 |
| 1760012108 | Majid Sabour Md. PC. | Family Medicine | 1125 S Beverly Dr Ste 420, Los Angeles, CA 90035-1191 | 2020-01-24 |
| 1164061461 | Sequoia Quality Health Inc | Family Medicine | 2007 Wilshire Blvd Fl 3, Los Angeles, CA 90057-3519 | 2020-01-03 |
| 1437792447 | Northeast Community Clinic | Family Medicine | 1414 S Grand Ave Ste 300, Los Angeles, CA 90015-3072 | 2019-10-22 |
| 1386298867 | Prompt Healthcare, Inc., A Medical Corporation | Family Medicine | 1972 West 48th Street, #a, Los Angeles, CA 90062 | 2019-08-01 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90061 |
Please comment or provide details below to improve the information on PARKLANE MEDICAL GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.