Organization
ICM MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANUEL SIMA MD (PRESIDENT)
(310) 855-0556
Entity
Organization
Contact information
Practice address
211 N PRAIRIE AVE, INGLEWOOD, CA 90301-1412
(310) 855-0556
(310) 419-9475
Mailing address
PO BOX 1698, INGLEWOOD, CA 90308-1698
(310) 855-0556
(310) 419-9475
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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