South Atlantic Medical Group

LBN: South Atlantic Medical Group
South Atlantic Medical Group is an health care organization with primary practice located at 2616 Clarendon Ave , Huntington Park CA 90255-4120. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as the primary health care specialty. South Atlantic Medical Group can be contacted via phone (323) 589-6633, or through Kahen, Nissan via phone (323) 725-0167.

Contact Information

Primary practice address
2616 Clarendon Ave Huntington Park CA 90255-4120
Phone: (323) 589-6633
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kahen, Nissan Doctor of Medicine (MD)
Phone: (323) 725-0167

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X A41061 California

Profile Details

NPI number 1629251541
LBN Legal business name South Atlantic Medical Group
DBA Doing business as
Authorized official Kahen, Nissan Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 13th, 2007
Last updated Dec 13th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629251541 NPPES
California MEDICAID GR0020632

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