# SOUTH LOS ANGELES MEDICAL GROUP PROFESSIONAL CORPORATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1538095385
- **Authorized official:** JENNY LOPEZ (OFFICE MANAGER)
- **Authorized official phone:** (562) 832-6380

## Contact information

- **Practice address:** 2804 W FLORENCE AVE, LOS ANGELES, CA 90043-5142
- **Practice address phone:** (323) 807-2980
- **Mailing address:** 2804 W FLORENCE AVE, LOS ANGELES, CA 90043-5142
- **Mailing address phone:** (323) 807-2980

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/19/2026
- **Last updated:** 09/23/2026