South Atlantic Medical Group

NPI #1306029806 in Gardena, California

Provider Information

NPI Number: 1306029806
Entity Type: Organization
Organization Name: South Atlantic Medical Group
Primary Specialty: General Practice
Enumeration Date: Dec 7, 2007
Last Updated: Dec 13, 2007

Practice Location

Address: 1030 W GARDENA BLVD
City: Gardena
State: California
ZIP Code: 90247-4956
Phone: (310) 323-9999

Authorized Official

Name: NISSAN KAHEN, M.D.
Title: MEDICAL DIRECTOR
Phone: (323) 725-0167

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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