Healthcare Provider Details

I. General information

NPI: 1184891632
Provider Name (Legal Business Name): GCAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2370 W CARSON ST STE 200
TORRANCE CA
90501-7105
US

IV. Provider business mailing address

2370 W CARSON ST STE 200
TORRANCE CA
90501-7105
US

V. Phone/Fax

Practice location:
  • Phone: 310-782-7662
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA38304
License Number StateCA

VIII. Authorized Official

Name: MR. DON KANG
Title or Position: MANAGEMENT
Credential:
Phone: 310-782-7662