Addis Medical Group a Medical Corporation
Organization Active NPI Psychiatry Physician · Torrance, CA
NPI 1013289339 · NPPES record last updated Sep 11, 2014
Key facts
- NPI
- 1013289339
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- A101106 (CA)
- Legal business name
- ADDIS MEDICAL GROUP A MEDICAL CORPORATION
- Practice address
- 23700 Camino del Sol
Torrance, CA 90505-5017 - Phone
- (310) 530-1151
- Fax
- (310) 626-9390
- NPI assigned
- Feb 1, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Hiruy H Gessesse, MD
- Title
- Owner
- Phone
- (424) 400-7748
Practitioners 26
-
Charilyn Bringas, NP
-
Hiruy Haile Gessesse, M.D.
-
Lisa Kahn, PH.D.
-
Anna I Lau, PH.D.
-
Eunice Lee, PMHNP-BC
-
Bruce A Lyons, PH.D.
-
Assefa Ejigu Mekonnen, PMHNP
-
Ajmal Mohammad, N.P.
-
Esther U Okafor, FNP/PMHNP/DNP
-
Miguel Angel Quiroz, PMHNP
-
Picolya Katice Robinson, PSY. D
-
Felix Umukoro, MSN, RN, PMHNP
-
Shane Manalang, PHYSICIAN ASSISTANT
-
Sarah Cho Ko, PMHNP
-
Richard Monforte, PMHNP-BC
-
Kesha Saucier, NP, LMFT, LEP
-
Fun Wing Wong, PMHNP
-
Yaw O Asamoah, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120522001225 | CA | Part B Supplier - Clinic/Group Practice | 0941463335 |
Receives reassigned benefits from 26 practitioners Practice locations: Culver City, CA; Long Beach, CA; Panorama City, CA; Perris, CA; San Pedro, CA; Torrance, CA; Cerritos, CA |
National Provider Directory
Locations
1416 W 6th St
San Pedro, CA 90732
Phone (310) 832-6431
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | A101106 | CA | Yes |
Addresses
Primary practice location
23700 Camino del Sol
Torrance, CA 90505-5017
Mailing address
PO Box 4570
Palos Verdes Peninsula, CA 90274-9607
Phone (424) 400-7748
Other providers in Torrance, CA
- Rhea Ruth Adams
- Tammie Lajuana Adams
- Tyonna Adams
- Rukky Adanike
- Irina Addes
- Grace O Adeagbo
- Asiata Oyinlade Adekunle
- Zainab M Aderounmu
- Chelsea Ades
- Adf Investments LLC
All providers in Torrance, CA · Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.