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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