Healthcare Provider Details

I. General information

NPI: 1558703017
Provider Name (Legal Business Name): CENTURY FAMILY MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16900 LAKEWOOD BLVD #308
BELLFLOWER CA
90706-8805
US

IV. Provider business mailing address

8679 W PICO BLVD
LOS ANGELES CA
90035-2315
US

V. Phone/Fax

Practice location:
  • Phone: 310-553-1200
  • Fax: 310-553-1216
Mailing address:
  • Phone: 310-553-1200
  • Fax: 310-553-1216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ALBERT A NASSIR
Title or Position: PRESIDENT
Credential: MD
Phone: 310-553-1200