# GRUPO MEDICO SAN PEDRO INC

> 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
- **Other names:** GRUPO MEDICO SAN PEDRO
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598223299
- **Authorized official:** JOSEPH I KANG MD (MEDICAL DIRECTOR / OWNER)
- **Authorized official phone:** (562) 716-4468

## Contact information

- **Practice address:** 13939 SAN ANTONIO DR, NORWALK, CA 90650-4036
- **Practice address phone:** (562) 807-3777
- **Practice address fax:** (562) 807-2333
- **Mailing address:** 13939 SAN ANTONIO DR, NORWALK, CA 90650-4036
- **Mailing address phone:** (562) 807-3777
- **Mailing address fax:** (562) 807-2333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/12/2019
- **Last updated:** 03/12/2019