Healthcare Provider Details

I. General information

NPI: 1376634501
Provider Name (Legal Business Name): GEORGE HUTHSTEINER II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 REDONDO AVE STE 400
LONG BEACH CA
90806-2330
US

IV. Provider business mailing address

153 BAY SHORE AVE
LONG BEACH CA
90803-3452
US

V. Phone/Fax

Practice location:
  • Phone: 562-424-8307
  • Fax: 562-424-2007
Mailing address:
  • Phone: 562-424-8307
  • Fax: 562-424-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberG40478
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG40478
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: