Organization
SOUTH CERRITOS MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONCHITA YATAR GOINGS M.D. (PHYSICIAN)
(562) 809-1434
Entity
Organization
Contact information
Practice address
20927 NORWALK BLVD, LAKEWOOD, CA 90715-1545
(562) 809-1434
(562) 809-1526
Mailing address
13381 SILVER BERRY CIR, CERRITOS, CA 90703-1374
(562) 809-1434
(562) 809-1526
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A41071
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A41071
STATE LICENSE
CA
01
—
W13073
GROUP NUMBER
CA
Enumeration date
04/16/2007
Last updated
08/22/2020
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