Healthcare Provider Details

I. General information

NPI: 1528333101
Provider Name (Legal Business Name): CENTINELA FREEMAN EMERGENCY MEDICAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2012
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E HARDY ST
INGLEWOOD CA
90301-4011
US

IV. Provider business mailing address

PO BOX 80487
CITY OF INDUSTRY CA
91716-8404
US

V. Phone/Fax

Practice location:
  • Phone: 310-379-2134
  • Fax: 310-379-4856
Mailing address:
  • Phone: 310-321-0143
  • Fax: 310-379-4856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK R. BELL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-321-0143