Centinela Medical Center of South Bay Inc.

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

FNP40289 Issued in CA

Legal business name

CENTINELA MEDICAL CENTER OF SOUTH BAY INC.

Practice address

1125 Cherry Ave
Long Beach, CA 90813-3911

Phone

(562) 591-1111

NPI assigned

Jul 10, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jerry A. Okonkwoaguolu, MD, PHDNPI 1134239932

Title

Medical Director

Phone

(562) 591-1111

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Jerry Azubuike Okonkwoaguolu, MD

  • Family Medicine Physician
  • Lawndale, CA
  • NPI 1134239932
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396224000000",
    "number": "1912219635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1405",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902606305",
            "telephone_number": "562-591-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 CHERRY AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133911",
            "telephone_number": "562-591-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTINELA MEDICAL CENTER OF SOUTH BAY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-10",
        "last_updated": "2014-03-31",
        "status": "A",
        "authorized_official_last_name": "OKONKWOAGUOLU",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "562-591-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "FNP40289",
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "CA",
            "license": "FNP40289",
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "CA",
            "license": "FNP40289",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Center for Oculofacial and Orbital Surgery
• Center for Specialty Surgery LLC
• Center of Surgical Excellence LLC
• Centers for Family Medicine - Fhclb
• Centigrade Medical Supply &Equipment
• Central Neighborhood Health Foundat
• Cep America - Anesthesia PC
• Cep America - California
• Cep America - Intensivists PC
• Sabrina M Cerbone, RN

• Multi-Specialty Clinic/Center in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; 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.