Organization
CENTINELA MEDICAL GROUP
Active
Parent organization
PARKLANE MEDICAL GROUP
Other names
PARKLANE MEDICAL GROUP INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARKLANE MEDICAL GROUP
Authorized official
DR. GEORGE CHIKE IFEORAH LAC,QME (DIRECTOR)
(310) 367-3107
Entity
Organization
Contact information
Practice address
4405 S MAIN ST, LOS ANGELES, CA 90037-2731
(323) 231-0965
(323) 231-6512
Mailing address
4405 S MAIN ST, LOS ANGELES, CA 90037-2731
(323) 231-0965
(323) 231-6512
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
FNP31076
CA
Other
Enumeration date
08/08/2014
Last updated
08/08/2014
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