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Contact Information

VISTA BAY MEDICAL GROUP
21320 HAWTHORNE BLVD
207
TORRANCE, CA90503-5606
 Phone: 310-540-6770
 Fax: 310-540-2004
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Trauma

207XX0801X 02 Physician/General Surgery
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for VISTA BAY MEDICAL GROUP

NPI Number 1386841278
LBN Legal business name VISTA BAY MEDICAL GROUP
Authorized official JENS DIMMICK - (PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 07/02/2007
Last updated 09/11/2025 - About 9 months ago
Identifiers
CA License # A22090
CA License # G26557
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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