Centinela Medical Group

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CENTINELA MEDICAL GROUP

Practice address

933 Centinela Ave
B
Inglewood, CA 90302-1501

Phone

(310) 677-5090

Fax

(310) 677-7302

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

George Chikelue Ifeorah, LAC

Title

Director

Phone

(310) 677-5090

Specialties & licenses 1

Addresses

Other names 1

• PARKLANE MEDICAL GROUP INC Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 6

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

• Nkonye Ada Ezeobah

  • Addiction (Substance Use Disorder) Counselor
  • Torrance, CA
  • NPI 1689706699

  CA

  Medicare reassignment NPD
• Anita W Hibler, M.D.

  • Specialist
  • Inglewood, CA
  • NPI 1306062476

  CA, Single Specialty

  Medicare reassignment NPD
• Hazel McKillop, MD

  • Pulmonary Disease Physician
  • Los Angeles, CA
  • NPI 1396766994

  CA

  Medicare reassignment NPD
• Jamshid Ebrami, PA-C

  • Medical Physician Assistant
  • Los Angeles, CA
  • NPI 1902148026

  CA

  Medicare reassignment
• Kalaki Marks Clarke, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1639393366

  Single Specialty

  NPD (past)
• Rubina Shaheen, MD

  • General Practice Physician
  • Anaheim, CA
  • NPI 1215100490

  General Practice

  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363737600000",
    "number": "1902936099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 CENTINELA AVE",
            "address_2": "B",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903021501",
            "telephone_number": "310-677-5090",
            "fax_number": "310-677-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 CENTINELA AVE",
            "address_2": "B",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903021501",
            "telephone_number": "310-677-5090",
            "fax_number": "310-677-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTINELA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2013-03-20",
        "status": "A",
        "authorized_official_last_name": "IFEORAH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "CHIKELUE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "310-677-5090",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARKLANE MEDICAL GROUP INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Centinela Assisted Living Management LLC
• Centinela Freeman Emergency Medical Associates
• Centinela Freeman Emergency Medical Associates, Inc.
• Centinela Hospitalist Medical Group Inc
• Centinela House Physicians Medical Group, Inc.
• Centinela Radiology Medical Group
• Centinela Recovery Group, Inc.
• Centinela Skilled Nursing & Wellness Centre East, LLC
• Centinela Skilled Nursing & Wellness Centre West, LLC
• Centinela Valley Endoscopy Center Inc.

• All providers in Inglewood, CA
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2013; 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.