South Atlantic Medical Group

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A41061 Issued in CA

Legal business name

SOUTH ATLANTIC MEDICAL GROUP

Practice address

6300 Florence Ave
Bell Gardens, CA 90201-8900

Phone

(562) 806-6667

NPI assigned

Dec 13, 2007

Organization subpart

No

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

Authorized official

Name

Nissan Kahen, M.D.

Title

Medical Director

Phone

(323) 725-0167

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

South Atlantic 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.

• South Atlantic Medical Group

  • General Practice Physician
  • Huntington Park, CA
  • NPI 1629251541
  NPD tax ID
• South Atlantic Medical Group

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1790705267
  NPD tax ID

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1710160635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5504 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900224104",
            "telephone_number": "323-725-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 FLORENCE AVE",
            "city": "BELL GARDENS",
            "state": "CA",
            "postal_code": "902018900",
            "telephone_number": "562-806-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ATLANTIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "KAHEN",
        "authorized_official_first_name": "NISSAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "323-725-0167",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A41061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0020633",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellen Silva
• Martha I Silva
• Suresh Narain Simlote, DDS
• Jordan Smith
• Yuan Jeanie Son
• Spiritt Family Services
• Brooke M Stamm
• Jovani Suarez
• Suk Hoon Yun,DDS,Inc. Bell Gardens Dental Group
• Super Market Pharmacy

• General Practice Physician in Bell Gardens, CA
• Providers in Bell Gardens, 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 Jun 17, 2008; 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.