MEDICARE: INTEGRATED HEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251F00000X	Home Infusion Agency	PHY46298	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	ZZZ45652Z	OTHER	CA	BLUE SHIELD OF CA. PROV #
3	003739	OTHER	CA	BLUE CROSS CA PROV #

General Provider Information

NPI Number	:	1689686107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED HEALTH SERVICES

Provider Business Mailing Address
First Line	:	5584 N PARAMOUNT BLVD
Second Line	:	101
City	:	LONG BEACH
State	:	CA
Zip	:	90805-5133
Country	:	US
Telephone Number	:	562-408-1173
Fax Number	:	562-408-3075

Provider Business Practice Location Address
First Line	:	5584 N PARAMOUNT BLVD
Second Line	:	101
City	:	LONG BEACH
State	:	CA
Zip	:	90805-5133
Country	:	US
Telephone Number	:	562-408-1173
Fax Number	:	562-408-3075

Authorized Official
Title or Position	:	CEO
Name	:	MR. STEPHEN M STROCKER
Credential	:
Telephone Number	:	562-408-1173

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	08/22/2020

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Directions to “INTEGRATED HEALTH SERVICES ” Practice Location

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