Organization
CENTINELA ANESTHESIA MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY C. JUAREZ M.D. (PRESIDENT)
(310) 792-0601
Entity
Organization
Contact information
Practice address
555 E HARDY ST, INGLEWOOD, CA 90301-4011
(310) 673-4660
Mailing address
PO BOX 2866, TORRANCE, CA 90509-2866
(310) 792-0601
(310) 792-9062
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0080970
—
CA
01
—
ZZZ54786Z
BLUE SHIELD
—
Enumeration date
04/24/2006
Last updated
09/11/2025
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