MEDICARE: DR. BETTY C FLETCHER MD

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	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	G42666	CA

General Provider Information

NPI Number	:	1760684716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETTY C FLETCHER MD

Provider Business Mailing Address
First Line	:	500 ALAMITOS AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802
Country	:	US
Telephone Number	:	562-432-5661
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 ALAMITOS AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-1614
Country	:	US
Telephone Number	:	562-432-5661
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	10/29/2012

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