GOOD LIFE MEDICAL GROUP, INC. (NPI# 1316940828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316940828 |
| Entity Type | Organization |
| Organization Name | GOOD LIFE MEDICAL GROUP, INC. |
| Practice Address |
3650 South St Ste 204 Lakewood CA 90712-1521 |
| Practice Telephone | 5626028841 |
| Practice Fax Number | 5626028843 |
| Mailing Telephone | 5626028841 |
| Mailing Fax Number | 5626028843 |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2010-11-14 |
| Authorized Official Name | DR. PETER HUGH (C.E.O.) |
| Authorized Official Telephone | 5626028841 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | A050818 | CA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 20A6005 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0092320 | 05 |
| Street Address |
3650 SOUTH ST STE 204 |
| City | LAKEWOOD |
| State | CA |
| Zip Code | 90712-1521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295188282 | Nancy Perley | Nurse Practitioner | 3650 South St, Suite 208, Lakewood, CA 90712-1502 | 2016-07-14 |
| 1659773349 | Pacific Heart and Lung Surgeons Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3650 South St, Ste 206, Lakewood, CA 90712-1502 | 2014-09-24 |
| 1710262571 | Jamal Hussain Md Inc | Clinic/Center | 3650 South St, Ste 105, Lakewood, CA 90712-1502 | 2011-10-12 |
| 1649584285 | Michael J Perley Md Inc | Internal Medicine | 3650 South St, Suite 208, Lakewood, CA 90712-1502 | 2010-08-05 |
| 1366631962 | Navrose S Grewal | Surgery | 3650 South St, Suite 206, Lakewood, CA 90712-1502 | 2007-10-18 |
| 1306039300 | Shyam Dahiya Md Inc | Surgery | 3650 South St, Suite 412, Lakewood, CA 90712-1502 | 2007-08-22 |
| 1093913147 | Milan Gaurang Rawal | Internal Medicine | 3650 South St, Suite 310, Lakewood, CA 90712-1502 | 2007-07-10 |
| 1770604407 | Lakewood Internal Medical Group | Clinic/Center | 3650 South St, Suite 110, Lakewood, CA 90712-1502 | 2007-04-02 |
| 1558481291 | Arthur Franklin Gelb | Internal Medicine | 3650 South St, Suite 308, Lakewood, CA 90712-1502 | 2007-03-29 |
| 1013037779 | Joel Douglas Epstein | Internal Medicine | 3650 South St, Suite 308, Lakewood, CA 90712-1502 | 2007-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689289944 | Createwellness LLC | Social Worker | 5250 Hayter Avenue, Lakewood, CA 90712 | 2020-09-14 |
| 1801451398 | Marilou Toquero Dental Corp | Durable Medical Equipment & Medical Supplies | 3203 Carson St Suite 2, Lakewood, CA 90712 | 2019-05-09 |
| 1225510126 | N Ozder Dental Practice Inc | Clinic/Center | 5037 Lakewood Blvd, Lakewood, CA 90712 | 2018-09-06 |
| 1003394446 | Robert Michael Schlesinger | Counselor | 5150 Candlewood St Ste 13a, Lakewood, CA 90712 | 2018-07-28 |
| 1316439847 | P.r.i.s.m. Institute Inc. | Chiropractor | 5233 Premiere Ave, Lakewood, CA 90712 | 2018-05-31 |
| 1316477938 | Broadleaf Healthcare | Orthotist | 4345 Levelside Ave, Lakewood, CA 90712 | 2017-06-15 |
| 1679008049 | Adrienne Yoshiko Doi | Podiatrist | 3700 East South Street, Lakewood, CA 90712 | 2017-04-24 |
| 1841747334 | Garrison R Weaver-gourdeau | Chiropractor | 4115 E. South St, Lakewood, CA 90712 | 2016-09-01 |
| 1073967394 | Mirna S Rizkalla | Family Medicine | 3650 South St Ste 404, Lakewood, CA 90712 | 2016-04-22 |
| 1841657251 | Roxanna Jimenez | Rehabilitation Practitioner | 5818 Clark Ave, Lakewood, CA 90712 | 2016-01-15 |
| Find all providers in zip 90712 | ||||
| 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. |
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| 1952913774 | Scl Health Medical Group - Denver, LLC | Family Medicine | 325 S Teller St Ste 250, Lakewood, CO 80226-7429 | 2020-08-21 |
| 1356860803 | Front Range Clinic Inc. | Family Medicine | 1410 Vance St Ste 201, Lakewood, CO 80214-5435 | 2017-09-15 |
| 1912433756 | Julie Ann Foucher-urcuyo | Family Medicine | 14601 Detroit Ave, Fl 2, Lakewood, OH 44107 | 2017-05-11 |
| 1225563661 | Elizabeth Ann Rainbolt | Family Medicine | 14601 Detroit Ave Fl 2, Lakewood, OH 44107 | 2017-04-24 |
| 1083148324 | Stephanie Baker | Family Medicine | 255 S Routt St, Lakewood, CO 80228-2271 | 2017-04-13 |
| 1043766413 | Paladina Health, LLC | Family Medicine | 3701 Michelson St, Lakewood, CA 90712-1402 | 2016-08-26 |
| 1245686674 | Gary James Cantrell Jr. | Family Medicine | 12105 W Alameda Pkwy Ste 100, Lakewood, CO 80228-2832 | 2016-05-04 |
| 1073967394 | Mirna S Rizkalla | Family Medicine | 3650 South St Ste 404, Lakewood, CA 90712 | 2016-04-22 |
| 1194145656 | Mile High Wound and Hyperbaric Medicine Pllc | Family Medicine | 12065 W Auburn Dr, Lakewood, CO 80228-4765 | 2014-04-23 |
| Find all providers in LAKEWOOD | ||||
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| 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.