Organization
VISTA BAY MEDICAL GROUP
Active
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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