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Organization
SAN JUDAS TADEO MEDICAL GROUP, INC.
Active
Organization
SAN JUDAS TADEO MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROMMEL GONZALEZ MD (MEDICAL DIRECTOR)
(323) 821-4386
Entity
Organization
Contact information
Practice address
1000 S LA BREA AVE STE 2, INGLEWOOD, CA 90301-3869
(310) 330-4818
(310) 330-4822
Mailing address
1000 S LA BREA AVE STE 2, INGLEWOOD, CA 90301-3869
(310) 330-4818
(310) 330-4822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/03/2020
Last updated
11/03/2020
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