Healthcare Provider Details

I. General information

NPI: 1326812280
Provider Name (Legal Business Name): BEACH CITY WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2023
Last Update Date: 11/10/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1633 LONG BEACH BLVD
LONG BEACH CA
90813-1929
US

IV. Provider business mailing address

1633 LONG BEACH BLVD
LONG BEACH CA
90813-1929
US

V. Phone/Fax

Practice location:
  • Phone: 562-800-5520
  • Fax:
Mailing address:
  • Phone: 562-800-5520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VARUJAN GABUCHIAN
Title or Position: PRESIDENT
Credential:
Phone: 562-800-5520