NPIMap

Organization Active NPI

Children'S Medical Group, Inc.

  • Pediatrics Physician
  • Torrance, CA
National Provider Identifier
1003917048
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G13850 Issued in CA
Legal business name
CHILDREN'S MEDICAL GROUP, INC.
Practice address
3440 W. Lomita Blvd.
Suite 352
Torrance, CA 90505-4858
Phone
(310) 539-2445
Fax
(310) 539-0061
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laura Sergis, MDNPI 1598866527
Title
Chief Executive Officer
Phone
(310) 539-2445

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X G13850 CA Primary

Addresses

Primary practice location

3440 W. Lomita Blvd.
Suite 352
Torrance, CA 90505-4858

Mailing address

3440 Lomita Blvd Ste 352
Torrance, CA 90505-4821
Phone (310) 539-2445

Other names 2

  • Children's Medical Group Doing business as
  • Gwen Klyman-Friend M.D., Inc. Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1003917048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 LOMITA BLVD STE 352",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054821",
            "telephone_number": "310-539-2445",
            "fax_number": "310-539-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 W. LOMITA BLVD.",
            "address_2": "SUITE 352",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054858",
            "telephone_number": "310-539-2445",
            "fax_number": "310-539-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2021-07-01",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "SERGIS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "310-539-2445",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G13850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gwen Klyman-Friend M.D., Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Gwen Klyman-Friend M.D., Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.