Organization
CENTINELA MEDICAL CENTER OF SOUTH BAY INC.
Active
Organization
CENTINELA MEDICAL CENTER OF SOUTH BAY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY A. OKONKWOAGUOLU MD, PHD (MEDICAL DIRECTOR)
(562) 591-1111
Entity
Organization
Contact information
Practice address
1125 CHERRY AVE, LONG BEACH, CA 90813-3911
(562) 591-1111
Mailing address
PO BOX 1405, LAWNDALE, CA 90260-6305
(562) 591-1111
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
FNP40289
CA
261QU0200X
Urgent Care Clinic/Center
FNP40289
CA
261QX0100X
Occupational Medicine Clinic/Center
FNP40289
CA
Other
Enumeration date
07/10/2010
Last updated
03/31/2014
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