Organization
JAMES K. INGRAM INC
Active
Organization
JAMES K. INGRAM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES KENT INGRAM M.D. (PRESIDENT)
(310) 375-6576
Entity
Organization
Contact information
Practice address
23500 MADISON ST, TORRANCE, CA 90505-4702
(310) 784-2710
(310) 784-2716
Mailing address
225 S LAKE AVE, 535, PASADENA, CA 91101-3005
(626) 795-6596
(626) 795-8247
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G36031
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G360310
—
CA
01
—
00G360311
BLUE SHIELD
CA
Enumeration date
07/18/2006
Last updated
08/22/2020
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