Healthcare Provider Details

I. General information

NPI: 1568174282
Provider Name (Legal Business Name): SOUTHBAY CRITICAL CARE A MEDICAL PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2022
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 TORRANCE BLVD
TORRANCE CA
90503-4607
US

IV. Provider business mailing address

24422 AVENIDA DE LA CARLOTA STE 275
LAGUNA HILLS CA
92653-3669
US

V. Phone/Fax

Practice location:
  • Phone: 949-829-8299
  • Fax: 866-596-8696
Mailing address:
  • Phone: 949-829-8299
  • Fax: 866-596-8696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEX HAKIM
Title or Position: OWNER
Credential: MD
Phone: 310-210-8404