Healthcare Provider Details
I. General information
NPI: 1851208524
Provider Name (Legal Business Name): EQUITAS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2801 ATLANTIC AVE
LONG BEACH CA
90806-1701
US
IV. Provider business mailing address
25711 ESHELMAN AVE
LOMITA CA
90717-2641
US
V. Phone/Fax
- Phone: 562-933-2000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHAKIR
ULLAH
Title or Position: PRESIDENT
Credential: MD
Phone: 818-423-3320