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NPI Code Detail

MEDICARE: TWIN TOWN CORPORATION

MEDICARE: TWIN TOWN CORPORATION
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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center300128APCA

General Provider Information

NPI Number : 1972939718
Entity Type Code : Organization
Provider Name (Legal Business Name) : TWIN TOWN CORPORATION
Provider Business Mailing Address
First Line : 4281 KATELLA AVE STE 211
Second Line :
City : LOS ALAMITOS
State : CA
Zip : 90720-6500
Country : US
Telephone Number : 562-594-8844
Fax Number : 562-596-0058
Provider Business Practice Location Address
First Line : 4281 KATELLA AVE STE 211
Second Line :
City : LOS ALAMITOS
State : CA
Zip : 90720-6500
Country : US
Telephone Number : 562-594-8844
Fax Number : 562-596-0058
Authorized Official
Title or Position : CEO/ PRESIDENT
Name : MR. DAVID PAUL LISONBEE
Credential :
Telephone Number : 310-629-9669
Provider Enumeration Date : 09/25/2013
Last Update Date : 11/14/2025

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Directions to “TWIN TOWN CORPORATION ” Practice Location

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