Healthcare Provider Details

I. General information

NPI: 1992935639
Provider Name (Legal Business Name): PORT MEDICAL ASSOCIATE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 12/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 ATLANTIC AVE STE A
LONG BEACH CA
90806-2741
US

IV. Provider business mailing address

PO BOX 6200
LONG BEACH CA
90806
US

V. Phone/Fax

Practice location:
  • Phone: 562-426-4598
  • Fax: 562-318-3042
Mailing address:
  • Phone: 562-426-4598
  • Fax: 562-318-3042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberFNP39177
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KARIM A. SOLIMAN
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 562-426-4598