Healthcare Provider Details

I. General information

NPI: 1811843501
Provider Name (Legal Business Name): CONTINUUM HEALTH MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11821 CENTRALIA ST
LAKEWOOD CA
90715-1433
US

IV. Provider business mailing address

11821 CENTRALIA ST
LAKEWOOD CA
90715-1433
US

V. Phone/Fax

Practice location:
  • Phone: 559-728-4474
  • Fax: 559-603-2798
Mailing address:
  • Phone: 559-728-4474
  • Fax: 559-603-2798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: PAUL FORTALEZA
Title or Position: PRACTICE OWNER
Credential:
Phone: 559-728-4474