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CENTINELA MEDICAL GROUP
NPI 1043654676
General Practice in Los Angeles, CA

Active since April 25, 2013CLIA 05D0864748 · Waiver
12900 AVALON BLVD, LOS ANGELES, CA 90061(310) 538-5222(310) 532-7888 Get Directions Write a Review

NPPES record last updated: April 25, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Centinela Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTINELA MEDICAL GROUP (NPI 1043654676), doing business as Parklane Medical Group Inc, is a healthcare organization registered as a general practice in Los Angeles, California and active in the NPI registry since April 2013. The organization holds a CLIA Waiver certificate valid through June 10, 2028 and lists George Chike Ifeorah, Director, as its authorized official.

NPPES Registry Identity

NPI1043654676
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameCENTINELA MEDICAL GROUP
Location Address12900 AVALON BLVDLos Angeles, CA 90061-2734
Mailing Address12900 Avalon BlvdLos Angeles, CA 90061-2734 · (310) 538-5222 · Fax (310) 532-7888
Phone(310) 538-5222
Fax(310) 532-7888
Organization SubpartYesParent: Parklane Medical Group Inc
Authorized OfficialGeorge Chike IfeorahDirector · (310) 367-3107
Enumeration DateApril 25, 2013
✔ NPI 1043654676 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in CA · FNP 31076
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
12900 AVALON BLVD, Los Angeles, CA 90061
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Other Names 1

Former Legal Business NameParklane Medical Group Inc

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0864748

Centinela Medical Group · Los Angeles, CA
Active · expires Jun 10, 2028
CLIA Number05D0864748
Laboratory TypePhysician Office
Certificate Effective DateJune 11, 2026
Certificate Expiration DateJune 10, 2028
Laboratory DirectorAnita W. Hibler MD
Laboratory Phone(310) 538-5222
Laboratory LocationCentinela Medical Group12900 S Avalon Blvd, Los Angeles, CA 90061
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HAZEL MCKILLOP MD
Internal Medicine (Pulmonary Disease)
12900 AVALON BLVD
LOS ANGELES, CA 90061
Los Angeles County (310) 370-5888
MRS. RUTH A ABOIRALOR
Nurse Practitioner (Family)
12900 AVALON BLVD
LOS ANGELES, CA 90061
Los Angeles County (310) 483-8411

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Centinela Medical Group's NPI number?

The NPI number for Centinela Medical Group is 1043654676. It was assigned to this organization in the NPPES registry on April 25, 2013. The provider was formerly known as Parklane Medical Group Inc.

Where is Centinela Medical Group located?

Centinela Medical Group is located at 12900 Avalon Blvd, Los Angeles, CA 90061. The listed phone number is (310) 538-5222.

What is Centinela Medical Group's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Centinela Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0864748) is associated with this NPI, valid through June 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Centinela Medical Group was last updated on April 25, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.