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General NPI Number Information
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NPI Number | 1487318135
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Entity Type | Organization
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Legal Business Name | SFS MEDICAL GROUP, INC
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Dates
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Enumeration Date | 10/28/2021
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 8611 CRENSHAW BLVD STE 210
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City | INGLEWOOD
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State | CA
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Zip | 90305-3306
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Country | US
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Telephone | 310-910-8372
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Fax | 310-672-2280
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Provider Business Mailing Address
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Address Line | 9140 S NOBEL WAY
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City | INGLEWOOD
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State | CA
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Zip | 90305-1881
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Country | US
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Telephone | 310-910-8372
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. FIDELIA NNACHETAM
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Credential | NP
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Telephone | 310-910-8372
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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