Healthcare Provider Details

I. General information

NPI: 1811389547
Provider Name (Legal Business Name): MEMORIAL CARDIOLOGY MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2015
Last Update Date: 03/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2725 E BROADWAY
LONG BEACH CA
90803-5431
US

IV. Provider business mailing address

2898 LINDEN AVE
LONG BEACH CA
90806-1627
US

V. Phone/Fax

Practice location:
  • Phone: 562-434-4494
  • Fax: 562-434-8324
Mailing address:
  • Phone: 562-595-8671
  • Fax: 562-490-2015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DR. SERGE M TOBIAS
Title or Position: PRESIDENT
Credential: M.D
Phone: 562-595-8671