South Cerritos Medical Group, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A41071 Issued in CA

Legal business name

SOUTH CERRITOS MEDICAL GROUP, INC.

Practice address

20927 Norwalk Blvd
Lakewood, CA 90715-1545

Phone

(562) 809-1434

Fax

(562) 809-1526

NPI assigned

Apr 16, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Conchita Yatar Goings, M.D.NPI 1346429255

Title

Physician

Phone

(562) 809-1434

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Conchita Y Goings, MD

  • Family Medicine Physician
  • Lakewood, CA
  • NPI 1346429255
  NPD (past) Authorized official

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952526675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13381 SILVER BERRY CIR",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031374",
            "telephone_number": "562-809-1434",
            "fax_number": "562-809-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20927 NORWALK BLVD",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907151545",
            "telephone_number": "562-809-1434",
            "fax_number": "562-809-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CERRITOS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOINGS",
        "authorized_official_first_name": "CONCHITA",
        "authorized_official_middle_name": "YATAR",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "562-809-1434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A41071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "W13073",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A41071",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.