Healthcare Provider Details

I. General information

NPI: 1144590332
Provider Name (Legal Business Name): HEALTHCARE PARTNERS ASC-LB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2012
Last Update Date: 08/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 REDONDO AVE
LONG BEACH CA
90806-2325
US

IV. Provider business mailing address

P.O. BOX 6400
TORRANCE CA
90504-6400
US

V. Phone/Fax

Practice location:
  • Phone: 562-988-7000
  • Fax:
Mailing address:
  • Phone: 562-988-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN G. LIETHEN
Title or Position: SECRETARY
Credential:
Phone: 952-205-6262