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SOUTH ATLANTIC MEDICAL GROUP
NPI 1306029806
General Practice in Gardena, CA

Active since December 07, 2007
1030 W GARDENA BLVD, GARDENA, CA 90247(310) 323-9999 Get Directions Write a Review

NPPES record last updated: December 13, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About South Atlantic Medical Group NPPES

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

SOUTH ATLANTIC MEDICAL GROUP (NPI 1306029806) is a healthcare organization registered as a general practice in Gardena, California and active in the NPI registry since December 2007. The organization lists Nissan Kahen, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1306029806
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameSOUTH ATLANTIC MEDICAL GROUP
Location Address1030 W GARDENA BLVDGardena, CA 90247-4956
Mailing Address5504 Whittier BlvdLos Angeles, CA 90022-4104 · (323) 725-0167
Phone(310) 323-9999
Organization SubpartNo
Authorized OfficialNissan KahenMedical Director · (323) 725-0167
Enumeration DateDecember 7, 2007
Last NPPES UpdateDecember 13, 2007
✔ NPI 1306029806 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 · A41061
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
1030 W GARDENA BLVD, Gardena, CA 90247
Open in Google Maps ↗

Other Identifiers 1

MedicaidGR0020634CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

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

GHOLAM REZA HOSSEINIAN M.D.,
Family Medicine
1030 W GARDENA BLVD
GARDENA, CA 90247
Los Angeles County (310) 323-9999
JOCELYN RAMIREZ PHYSICIAN ASSISTANT
Physician Assistant
1030 W GARDENA BLVD
GARDENA, CA 90247
Los Angeles County (866) 981-3002
PAMELA OCAMPO DANIELS NP
Nurse Practitioner (Family)
1030 W GARDENA BLVD
GARDENA, CA 90247
Los Angeles County (424) 222-8800

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 South Atlantic Medical Group's NPI number?

The NPI number for South Atlantic Medical Group is 1306029806. It was assigned to this organization in the NPPES registry on December 7, 2007.

Where is South Atlantic Medical Group located?

South Atlantic Medical Group is located at 1030 W Gardena Blvd, Gardena, CA 90247. The listed phone number is (310) 323-9999.

What is South Atlantic Medical Group's specialty?

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

When was this NPI record last updated?

The NPPES record for South Atlantic Medical Group was last updated on December 13, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.