SOUTH CERRITOS MEDICAL GROUP, INC.


Address: 20927 Norwalk Blvd, Lakewood, CA 90715-1545
Phone: 5628091434

SOUTH CERRITOS MEDICAL GROUP, INC. (NPI# 1952526675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952526675
Entity Type Organization
Organization Name SOUTH CERRITOS MEDICAL GROUP, INC.
Practice Address 20927 Norwalk Blvd
Lakewood
CA 90715-1545
Mailing Address 13381 Silver Berry Cir
Cerritos
CA 90703-1374
Practice Telephone 5628091434
Practice Fax Number 5628091526
Mailing Telephone 5628091434
Mailing Fax Number 5628091526
Enumeration Date 2007-04-16
Last Update Date 2020-08-22
Authorized Official Name DR. CONCHITA YATAR GOINGS (PHYSICIAN)
Authorized Official Telephone 5628091434
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261Q00000X Clinic/Center A41071 CA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CA STATE LICENSE A41071 01
CA GROUP NUMBER W13073 01

Office Location

Street Address 20927 NORWALK BLVD
City LAKEWOOD
State CA
Zip Code 90715-1545

Providers in the same location

NPI Name Taxonomy Address Enumeration
1346429255 Conchita Y Goings Family Medicine 20927 Norwalk Blvd, Lakewood, CA 90715-1545 2007-10-26

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Taxonomy Information

Taxonomy Code 261Q00000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center

Taxonomy Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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Competitor

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City LAKEWOOD
Zip Code 90715

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Dataset Information

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.

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