| Craig J Gomberg, MD | |
|
555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90301 | |
| (310) 673-4660 | |
| Not Available |
| Full Name | Craig J Gomberg |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 33 Years |
| Location | 555 E Hardy St, Inglewood, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184603128 | NPI | - | NPPES |
| 050740CF74284 | Other | TRAILBLAZER | |
| 00G772250 | Medicaid | CA | |
| 050741CF74284 | Other | TRAILBLAZER | |
| 00G772250 | Other | BLUE SHIELD | |
| P00300453 | Other | RAILROAD MEDICARE | |
| 00G772250E02 | Other | CALOPTIMA | |
| 050739CF74284 | Other | TRAILBLAZER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | G77225 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Centinela Hospital Medical Center | Inglewood, CA | Hospital |
| Cedar-sinai Marina Del Rey Hospital | Marina del rey, CA | Hospital |
| Cedars-sinai Medical Center | Los angeles, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| United Medical Imaging Healthcare Inc | 0143311241 | 53 |
| Centinela Radiology Medical Group | 3476440215 | 9 |
| Beverly Radiology Medical Group Iii | 3476466376 | 307 |
| Entity Name | Beverly Radiology Medical Group Iii |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962457812 PECOS PAC ID: 3476466376 Enrollment ID: O20031106000784 |
| Entity Name | Kerlan-jobe Orthopaedic Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639141153 PECOS PAC ID: 6002712189 Enrollment ID: O20031209001130 |
| Entity Name | Beverly Radiology Medical Group Iii |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962457812 PECOS PAC ID: 3476466376 Enrollment ID: O20040202001145 |
| Entity Name | Centinela Radiology Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861475352 PECOS PAC ID: 3476440215 Enrollment ID: O20040304000414 |
| Entity Name | Beverly Radiology Medical Group Iii |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962457812 PECOS PAC ID: 3476466376 Enrollment ID: O20060221000914 |
| Entity Name | Icm Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467401000 PECOS PAC ID: 6709882491 Enrollment ID: O20061020000336 |
| Entity Name | United Medical Imaging Healthcare Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760572036 PECOS PAC ID: 0143311241 Enrollment ID: O20070803000169 |
| Mailing Address | Practice Location Address |
|---|---|
| Craig J Gomberg, MD Po Box 5686, Orange, CA 92863-5686 Ph: (888) 598-8819 | Craig J Gomberg, MD 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90301 Ph: (310) 673-4660 |
Dr. Walter Preston Maynard, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 125 N Prairie Ave, Inglewood, CA 90301 Phone: 310-671-9754 Fax: 310-671-3916 | |
Donald C Boger, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90301 Phone: 310-673-4660 | |
Arash David Tehranzadeh, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 555 E Hardy St, Inglewood, CA 90301 Phone: 310-673-4660 | |
Andrew P Kelly, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 555 E Hardy Street, Centinela Hospital Medical Center, Inglewood, CA 90301 Phone: 310-673-4660 | |
Michael J Dawson, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 555 E Hardy Street, Centinela Hospital Medical Center, Inglewood, CA 90301 Phone: 310-673-4660 | |
Donald S Mayekawa, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 555 E Hardy St, Centinela Hospital Medical Center, Inglewood, CA 90301 Phone: 310-673-4660 |