Healthcare Provider Details

I. General information

NPI: 1689911844
Provider Name (Legal Business Name): RONG BE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2013
Last Update Date: 01/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 ATLANTIC AVE SUITE 210
LONG BEACH CA
90807-4569
US

IV. Provider business mailing address

3530 ATLANTIC AVE SUITE 210
LONG BEACH CA
90807-4569
US

V. Phone/Fax

Practice location:
  • Phone: 562-424-1886
  • Fax: 562-424-2296
Mailing address:
  • Phone: 562-424-1886
  • Fax: 562-424-2296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: