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Organization
CITIZENS MEDICAL GROUP
Active
Organization
CITIZENS MEDICAL GROUP
Active
Parent organization
CITIZENS MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
CITIZENS MEDICAL GROUP
Authorized official
MS. JAN SHARP (ADMINISTRATOR)
(323) 464-1336
Entity
Organization
Contact information
Practice address
1300 N LA BREA AVE, LOS ANGELES, CA 90028
(323) 464-1336
(323) 464-2163
Mailing address
1300 N LA BREA AVE, LOS ANGELES, CA 90028
(323) 464-1336
(323) 464-2163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
CA
207R00000X
Internal Medicine Physician
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ815802
—
CA
Enumeration date
10/16/2006
Last updated
06/25/2008
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