Organization
PARKLANE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE C IFEORAH LAC (DIRECTOR)
(310) 637-3989
Entity
Organization
Contact information
Practice address
508 NORTH LONG BEACH BL., COMPTON, CA 90221
(310) 637-3989
(310) 637-9325
Mailing address
508 NORTH LONG BEACH BL., COMPTON, CA 90221
(310) 637-3989
(310) 637-9325
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0102060
—
CA
Enumeration date
05/15/2007
Last updated
08/22/2020
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