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Organization

SAN JUDAS TADEO MEDICAL GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROMMEL GONZALEZ MD (MEDICAL DIRECTOR)
(323) 821-4386
Entity
Organization

Contact information

Practice address
1000 S LA BREA AVE STE 2, INGLEWOOD, CA 90301-3869
(310) 330-4818
(310) 330-4822
Mailing address
1000 S LA BREA AVE STE 2, INGLEWOOD, CA 90301-3869
(310) 330-4818
(310) 330-4822

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
207V00000X
Obstetrics & Gynecology Physician
208000000X
Pediatrics Physician
208D00000X
General Practice Physician
Primary

Other

Enumeration date
11/03/2020
Last updated
11/03/2020
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