Organization
GASTROENTEROLOGY ASSOCIATES OF THE SOUTH BAY A PROFESS MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK H TAKEMURA M.D. (M.D.)
(310) 214-7236
Entity
Organization
Contact information
Practice address
20911 EARL STREET, SUITE 280, TORRANCE, CA 90503
(310) 214-7236
(310) 542-0334
Mailing address
20911 EARL STREET, SUITE 280, TORRANCE, CA 90503
(310) 214-7236
(310) 542-0334
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
G29961
CA
207RG0100X
Gastroenterology Physician
Primary
G58448
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100008536
RAILROAD
CA
01
—
100011914
RAILROAD
CA
Enumeration date
08/03/2006
Last updated
10/19/2010
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