SOUTHBAY ADVANCE MEDICAL GROUP, INC. (NPI# 1457373383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457373383 |
| Entity Type | Organization |
| Organization Name | SOUTHBAY ADVANCE MEDICAL GROUP, INC. |
| Practice Address |
15731 S Western Ave Gardena CA 90247-6157 |
| Practice Telephone | 3108080199 |
| Mailing Telephone | 3108080199 |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MORRIS HALFON (DIRECTOR) |
| Authorized Official Telephone | 3108080199 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | A27935 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
15731 S WESTERN AVE |
| City | GARDENA |
| State | CA |
| Zip Code | 90247-6157 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164905204 | Phuong Huynh | Chiropractor | 15731 S Western Ave, Gardena, CA 90247-6179 | 2018-09-14 |
| 1912383472 | Hong's Acupuncture, Chiropractic & Healing Center | Chiropractor | 15731 S Western Ave, Gardena, CA 90247-6179 | 2015-08-07 |
| 1578739801 | Hong's Healing Center Inc | Chiropractor | 15731 S Western Ave, Gardena, CA 90247-6157 | 2008-05-06 |
| 1740369305 | Seong Ho Hong | Acupuncturist | 15731 S Western Ave, Gardena, CA 90247-6157 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204707 | Melissa Reyes | Home Health Aide | 835 N Rosecrans Ave Apt 125, Gardena, CA 90247 | 2020-10-30 |
| 1538645569 | Christopher Jabarie Markham | Case Manager/Care Coordinator | 12817 S Hoover St Apt 14, Gardena, CA 90247 | 2018-07-12 |
| 1013404243 | Sunshine Community Resource Organization Center | Counselor | 1202 W 135th Street, Gardena, CA 90247 | 2018-04-13 |
| 1124537261 | Nina Vu | Pharmacist | 14416 Plum Lane, Unit 3, Gardena, CA 90247 | 2017-09-20 |
| 1356871008 | Delaram Moshfegh | Pharmacist | 1735 Artesia Blvd, Gardena, CA 90247 | 2017-06-15 |
| 1497290522 | Better Vision Optical | Eyewear Supplier (Equipment, not the service) | 1121 W Gardena Blvd Ste A, Gardena, CA 90247 | 2016-12-28 |
| 1013394832 | Lydia Gonzalez | Case Management | 13605 S Vermont Ave Apt 16, Gardena, CA 90247 | 2015-04-30 |
| 1396147682 | Daniel Medical Group, Inc. | Acupuncturist | 2015 W Redondo Beach Blvd., Ste F, Gardena, CA 90247 | 2014-09-18 |
| 1386913663 | Linda Doreen Humphries | Nurse Practitioner | 1141 W. Redondo Beach Blvd., Suite 402, Gardena, CA 90247 | 2011-12-15 |
| 1215229547 | Everett D Wong | Social Worker | 1045 W Redondo Beach Blvd Ste 150, Gardena, CA 90247 | 2011-05-04 |
| Find all providers in zip 90247 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922143247 | Thuan Van Nguyen | General Practice | 15420 Crenshaw Blvd, Gardena, CA 90249-4524 | 2007-02-21 |
| 1679580526 | Accie Mitchell | General Practice | 19210 S Vermont Ave, Bldg D, Suite 400, Gardena, CA 90248-4426 | 2006-08-02 |
| 1306029806 | South Atlantic Medical Group | General Practice | 1030 W Gardena Blvd, Gardena, CA 90247-4956 | 2007-12-07 |
| 1215936224 | Waleed S. Al-fadly | General Practice | 16000 S Vermont Ave, Gardena, CA 90247-4552 | 2005-07-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992986 | Lindsay Fry | General Practice | 375 Bonair St Apt 1, La Jolla, CA 92037-5911 | 2020-11-04 |
| 1255939674 | Kiira Health Practice Ca PC | General Practice | 123 S Figueroa St Apt 1202, Los Angeles, CA 90012-5490 | 2020-10-16 |
| 1851999627 | Golden State Medical Center PC | General Practice | 2551 San Ramon Valley Blvd Ste 108, San Ramon, CA 94583-1661 | 2020-10-14 |
| 1598362709 | Afua Takyi | General Practice | 1555 River Park Dr Ste 211, Sacramento, CA 95815-4604 | 2020-10-01 |
| 1316553530 | Kimberly Ann Callaway | General Practice | 4893 Drakewood Ter, San Diego, CA 92130-1406 | 2020-09-22 |
| 1376156109 | Gtl Medical Group Inc | General Practice | 14555 Hamlin St Ste 107, Van Nuys, CA 91411-1617 | 2020-08-31 |
| 1922611896 | Daniel Lynn Johnson | General Practice | 74075 El Paseo Ste B2, Palm Desert, CA 92260-4118 | 2020-08-28 |
| 1235755299 | Hofmeister Medical, PC | General Practice | 31735 Riverside Dr Ste K, Lake Elsinore, CA 92530-7816 | 2020-06-24 |
| 1033733779 | South Bay Regenerative Medical Spa Inc | General Practice | 412 S Pacific Coast Hwy Ste 100, Redondo Beach, CA 90277-3712 | 2020-05-28 |
| 1568085041 | Integrated Advanced Medicine Inc | General Practice | 210 S Grand Ave Ste 408, Glendora, CA 91741-4282 | 2020-05-19 |
| Find all providers with the same taxonomy | ||||
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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.