Parklane Medical Group

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PARKLANE MEDICAL GROUP

Practice address

508 North Long Beach BL.
Compton, CA 90221

Phone

(310) 637-3989

Fax

(310) 637-9325

NPI assigned

May 15, 2007

Organization subpart

No

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

Authorized official

Name

George C Ifeorah, LAC

Title

Director

Phone

(310) 637-3989

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Parklane Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Parklane Medical Group

  dba Centinela Medical Group

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1134335128
  NPD tax ID
• Parklane Medical Group

  • Family Medicine Physician
  • Inglewood, CA
  • NPI 1164588141
  NPD tax ID

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336355320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 NORTH LONG BEACH BL.",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "90221",
            "telephone_number": "310-637-3989",
            "fax_number": "310-637-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 NORTH LONG BEACH BL.",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "90221",
            "telephone_number": "310-637-3989",
            "fax_number": "310-637-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKLANE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IFEORAH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "310-637-3989",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0102060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cristabel Palomarez
• Shailesh S Parikh, D.D.S.
• Kitae Kevin Park, MD
• Carol Ann Parker
• Wynette R Parker
• Sonali Patel, FNP
• Evelyn Patino
• Miriam Patino, ASW
• Jataja Patterson
• Teri Suzanne Paulsen, PSY.D.

• General Practice Physician in Compton, CA
• Providers in Compton, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.