NPIMap

Organization Active NPI

Centinela Radiology Medical Group

  • Diagnostic Radiology Physician
  • Inglewood, CA
National Provider Identifier
1861475352
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CENTINELA RADIOLOGY MEDICAL GROUP
Practice address
555 E Hardy St
Centinela Hospital Medical Center
Inglewood, CA 90301-4011
Phone
(310) 673-4660
NPI assigned
Nov 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Authorized official

Name
Craig J Gomberg, MDNPI 1184603128
Title
Partner
Phone
(562) 761-7479

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
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

555 E Hardy St
Centinela Hospital Medical Center
Inglewood, CA 90301-4011

Mailing address

PO Box 516068
Los Angeles, CA 90051-1930
Phone (310) 419-0597

Other identifiers 12

IdentifierTypeStateIssuer
CR0166OtherRAILROAD MEDICARE
ZZZ65765ZOtherBLUE SHIELD
GR0010880MedicaidCA
GR0010881MedicaidCA
ZZZ64951ZOtherBLUE SHIELD
ZZZ64952ZOtherBLUE SHIELD
GR0010882OtherCALOPTIMA
GR0010883OtherCALOPTIMA
GR0010883MedicaidCA
GR0010882MedicaidCA
GR0010881OtherCALOPTIMA
ZZZ94679ZOtherBLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040304000414 CA Part B Supplier - Clinic/Group Practice 3476440215 Receives reassigned benefits from 12 practitioners
Practice locations: Inglewood, CA; Marina del Rey, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1861475352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 516068",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900511930",
            "telephone_number": "310-419-0597",
            "fax_number": "714-919-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E HARDY ST",
            "address_2": "CENTINELA HOSPITAL MEDICAL CENTER",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903014011",
            "telephone_number": "310-673-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTINELA RADIOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "GOMBERG",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "562-761-7479",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CR0166",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ65765Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0010880",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0010881",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ64951Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ64952Z",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALOPTIMA",
            "identifier": "GR0010882",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALOPTIMA",
            "identifier": "GR0010883",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0010883",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0010882",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALOPTIMA",
            "identifier": "GR0010881",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ94679Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2026; 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.