NPIMap

Organization Active NPI

South Bay Gastroenterology Medical Group

  • Gastroenterology Physician
  • Torrance, CA
National Provider Identifier
1609893619
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
SOUTH BAY GASTROENTEROLOGY MEDICAL GROUP
Practice address
23456 Hawthorne Blvd Ste 300
Torrance, CA 90505-4716
Phone
(310) 539-2055
Fax
(310) 539-0199
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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

Authorized official

Name
Dr. Oren Zaidel, M.D.NPI 1689602195
Title
Medical Director
Phone
(310) 539-2055

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
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

23456 Hawthorne Blvd Ste 300
Torrance, CA 90505-4716

Mailing address

23456 Hawthorne Blvd Ste 300
Torrance, CA 90505-4716
Phone (310) 539-2055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050719001139 CA Part B Supplier - Clinic/Group Practice 4183651375 Receives reassigned benefits from 13 practitioners
Practice locations: El Segundo, CA; Torrance, CA

National Provider Directory

National Provider Directory

Locations

23560 Madison St
Ste 115
Torrance, CA 90505

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1609893619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23456 HAWTHORNE BLVD STE 300",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054716",
            "telephone_number": "310-539-2055",
            "fax_number": "310-539-0199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23456 HAWTHORNE BLVD STE 300",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054716",
            "telephone_number": "310-539-2055",
            "fax_number": "310-539-0199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY GASTROENTEROLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "ZAIDEL",
        "authorized_official_first_name": "OREN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-539-2055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.