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Organization

VISTA BAY MEDICAL GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JENS W DIMMICK M.D. (PHYSICIAN)
(310) 540-6770
Entity
Organization

Contact information

Practice address
21320 HAWTHORNE BLVD, 207, TORRANCE, CA 90503-5606
(310) 540-6770
(310) 540-2004
Mailing address
21320 HAWTHORNE BLVD, 207, TORRANCE, CA 90503-5606
(310) 540-6770
(310) 540-2004

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G26557
CA
207XX0801X
Orthopaedic Trauma Physician
Primary
A22090
CA

Other

Enumeration date
07/02/2007
Last updated
09/11/2025
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