Organization
CC SOUTHBAY MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGGIELYZ YOSORES PADILLA (CFO)
(562) 316-6555
Entity
Organization
Contact information
Practice address
3655 LOMITA BLVD STE 421, TORRANCE, CA 90505-1934
(562) 316-6555
Mailing address
3655 LOMITA BLVD STE 421, TORRANCE, CA 90505-1934
(310) 540-5464
(310) 540-4761
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/31/2025
Last updated
06/25/2026
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