Organization
COMMONS CLINIC MEDICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN ANN SCARAFIA (VICE PRESIDENT)
(812) 629-3592
Entity
Organization
Contact information
Practice address
13160 MINDANAO WAY STE 300, MARINA DEL REY, CA 90292-6393
(310) 437-7925
Mailing address
13160 MINDANAO WAY STE 300, MARINA DEL REY, CA 90292-6393
(812) 629-3592
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
11/29/2021
Last updated
05/14/2024
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