OrganizationActive
Bedside Gtube Replacement and Management
NPI 1780179770 · Physician Assistant · Los Angeles, CA
Provider details
- NPI number
- 1780179770
- Entity type
- Organization
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- John Sangmoah, Ceo/President(323) 200-4524
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Skilled Nursing Facility314000000X
Nursing & Custodial Care Facilities
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11429 Berendo Ave
Los Angeles, CA 90044-1202
Phone: (323) 200-4524
Street-level locationGet directions
Mailing address
11429 Berendo Ave
Los Angeles, CA 90044-1202
Registry dates
- Enumerated
- 2018-06-22
- Last updated
- 2022-12-17
- Certified
- 2022-12-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.