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Organization
SANA MEDICAL GROUP, INC.
Active
Organization
SANA MEDICAL GROUP, INC.
Active
Other names
Sana Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE L VILLAGOMEZ M.D. (PRESIDENT)
(310) 398-3803
Entity
Organization
Contact information
Practice address
12099 W WASHINGTON BLVD, STE 400, LOS ANGELES, CA 90066-5882
(310) 398-3803
Mailing address
12099 W WASHINGTON BLVD, STE 400, LOS ANGELES, CA 90066-5882
(310) 398-3803
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G69567
CA
208D00000X
General Practice Physician
A61283
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0086970
MEDI-CAL
CA
Enumeration date
01/08/2008
Last updated
12/08/2010
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