Healthcare Provider Details

I. General information

NPI: 1588930085
Provider Name (Legal Business Name): ERIC MORLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 06/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 N BELLFLOWER BLVD
LONG BEACH CA
90815
US

IV. Provider business mailing address

2110 N BELLFLOWER BLVD
LONG BEACH CA
90815-3126
US

V. Phone/Fax

Practice location:
  • Phone: 562-346-2222
  • Fax:
Mailing address:
  • Phone: 562-346-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA139815
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: