South Atlantic Medical Group Ipa
NPI #1114193182 in Los Angeles, California
Provider Information
- NPI Number
- 1114193182
- Entity Type
- Organization
- Organization Name
- South Atlantic Medical Group Ipa
- Primary Specialty
- Exclusive Provider Organization
- Enumeration Date
- Apr 30, 2008
- Last Updated
- Apr 30, 2008
Practice Location
- Address
- 5504 WHITTIER BLVD
- City
- Los Angeles
- State
- California
- ZIP Code
- 90022-4104
- Phone
- (323) 725-0167
Authorized Official
- Name
- NISSAN KAHEN, M.D.
- Title
- MEDICAL DIRECTOR
- Phone
- (323) 725-0167
Specialties & Taxonomy Codes
| Specialty |
|---|
| Exclusive Provider Organization |
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