Healthcare Provider Details

I. General information

NPI: 1578783221
Provider Name (Legal Business Name): SOUTH BAY COMPREHENSIVE MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 CRENSHAW BLVD
TORRANCE CA
90501-2433
US

IV. Provider business mailing address

1408 CRENSHAW BLVD
TORRANCE CA
90501-2433
US

V. Phone/Fax

Practice location:
  • Phone: 310-328-3738
  • Fax:
Mailing address:
  • Phone: 310-328-3738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC22422
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA86714
License Number StateCA

VIII. Authorized Official

Name: MRS. CATHY MARY RITTERBUSH
Title or Position: OFFICE ADMIN.
Credential:
Phone: 310-328-3738