# PARKLANE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336355320
- **Authorized official:** GEORGE C IFEORAH LAC (DIRECTOR)
- **Authorized official phone:** (310) 637-3989

## Contact information

- **Practice address:** 508 NORTH LONG BEACH BL., COMPTON, CA 90221
- **Practice address phone:** (310) 637-3989
- **Practice address fax:** (310) 637-9325
- **Mailing address:** 508 NORTH LONG BEACH BL., COMPTON, CA 90221
- **Mailing address phone:** (310) 637-3989
- **Mailing address fax:** (310) 637-9325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | CA | Yes |

## Other

- **Enumeration date:** 05/15/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0102060 | — | CA |