Healthcare Provider Details

I. General information

NPI: 1578010757
Provider Name (Legal Business Name): MEDI WEIGHTLOSS SOUTH BAY AND TORRANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2016
Last Update Date: 09/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3828 SEPULVEDA BLVD
TORRANCE CA
90505-2408
US

IV. Provider business mailing address

904 SILVER SPUR RD 497
ROLLING HILLS ESTATES CA
90274-3800
US

V. Phone/Fax

Practice location:
  • Phone: 310-504-1622
  • Fax: 424-271-9248
Mailing address:
  • Phone: 310-504-1622
  • Fax: 424-271-9248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK VOLPICELLI
Title or Position: OWNER/CEO/MEDICAL DIRECTOR
Credential: M.D.
Phone: 310-504-1622