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Organization
SOUTH MEDICAL GROUP
Active
Organization
SOUTH MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KWABENA OBENG (ADMINISTRATOR)
(310) 800-7963
Entity
Organization
Contact information
Practice address
1530 E SOUTH ST, LONG BEACH, CA 90805-4341
(562) 984-9200
Mailing address
1530 E SOUTH ST, LONG BEACH, CA 90805-4341
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Enumeration date
11/28/2008
Last updated
11/28/2008
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