Organization
LAX MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMSON YIRGU (PRESIDENT)
(310) 867-5556
Entity
Organization
Contact information
Practice address
5450 LINCOLN BLVD, PLAYA VISTA, CA 90094-2002
(310) 867-5556
(888) 302-0594
Mailing address
1223 WILSHIRE BLVD # 884, SANTA MONICA, CA 90403-5406
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
05/03/2022
Last updated
05/03/2022
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