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Organization

PACIFIC MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMSON YIRGU (MANAGER)
(310) 305-9200
Entity
Organization

Contact information

Practice address
5450 LINCOLN BLVD, PLAYA VISTA, CA 90094-2002
(310) 305-9200
(310) 305-2800
Mailing address
4712 ADMIRALTY WAY # 574, MARINA DEL REY, CA 90292-6905
(310) 305-9200
(310) 305-2800

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Enumeration date
09/02/2020
Last updated
09/02/2020
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