Healthcare Provider Details

I. General information

NPI: 1366790347
Provider Name (Legal Business Name): HEALTH MANAGEMENT SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2012
Last Update Date: 08/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2892 N BELLFLOWER BLVD STE 281
LONG BEACH CA
90815-1125
US

IV. Provider business mailing address

2892 N BELLFLOWER BLVD STE 281
LONG BEACH CA
90815-1125
US

V. Phone/Fax

Practice location:
  • Phone: 888-417-5163
  • Fax:
Mailing address:
  • Phone: 888-417-5163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberCMM71069F
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DWAYNE THOMPSON
Title or Position: BUSINESS ADMINISTRATOR
Credential:
Phone: 888-417-5163