Organization
CENTINELA MEDICAL GROUP
Active
Parent organization
PARKLANE MEDICAL GROUP INC
Other names
PARKLANE MEDICAL GROUP INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARKLANE MEDICAL GROUP INC
Authorized official
DR. GEORGE CHIKE IFEORAH LAC, QME (DIRECTOR)
(310) 367-3107
Entity
Organization
Contact information
Practice address
12900 AVALON BLVD, LOS ANGELES, CA 90061-2734
(310) 538-5222
(310) 532-7888
Mailing address
12900 AVALON BLVD, LOS ANGELES, CA 90061-2734
(310) 538-5222
(310) 532-7888
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
FNP 31076
CA
Other
Enumeration date
04/25/2013
Last updated
04/25/2013
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