Grupo Medico San Pedro Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

GRUPO MEDICO SAN PEDRO INC

Doing business as

Grupo Medico San Pedro

Practice address

13939 San Antonio Dr
Norwalk, CA 90650-4036

Phone

(562) 807-3777

Fax

(562) 807-2333

NPI assigned

Mar 12, 2019

Last updated

Mar 12, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph I Kang, MD

Title

Medical Director / Owner

Phone

(562) 716-4468

Specialties & licenses 4

Addresses

Other names 1

• GRUPO MEDICO SAN PEDRO Doing business as

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552348800000",
    "number": "1598223299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13939 SAN ANTONIO DR",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504036",
            "telephone_number": "562-807-3777",
            "fax_number": "562-807-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13939 SAN ANTONIO DR",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504036",
            "telephone_number": "562-807-3777",
            "fax_number": "562-807-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRUPO MEDICO SAN PEDRO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / OWNER",
        "authorized_official_telephone_number": "562-716-4468",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRUPO MEDICO SAN PEDRO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kayla Rae Griffin, LLPT
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• Linette Aileen Grint, LCSW
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• Ava Grysson, CST
• Cindy Guan
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• Elanie Briann Gudino
• Jocelyn Guerrero

• General Practice Physician in Norwalk, CA
• Providers in Norwalk, 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 Mar 12, 2019; 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.