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Organization
MADISON PARK FAMILY MEDICAL GROUP, INC.
Active
Organization
MADISON PARK FAMILY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDUARDO J ANORGA MD (MD)
(310) 944-9344
Entity
Organization
Contact information
Practice address
1970 SO PROSPECT AVE, STE 3, REDONDO BEACH, CA 90277
(310) 944-9344
(310) 944-9390
Mailing address
1970 SO PROSPECT AVE, STE 3, REDONDO BEACH, CA 90277
(310) 944-9344
(310) 944-9390
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G56001
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W13994
GROUP M CARE #
—
Enumeration date
12/09/2005
Last updated
08/13/2015
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