Organization
INNLEY MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HAZEL MCKILLOP M.D. (MEDICAL DOCTOR)
(310) 914-9150
Entity
Organization
Contact information
Practice address
4253 REDONDO BEACH BLVD, LAWNDALE, CA 90260-3341
(310) 914-9150
(310) 914-9705
Mailing address
4253 REDONDO BEACH BLVD, LAWNDALE, CA 90260-3341
(310) 914-9150
(310) 914-9705
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
A50837
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A508371
—
CA
Enumeration date
07/23/2006
Last updated
06/03/2014
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