Healthcare Provider Details

I. General information

NPI: 1669475570
Provider Name (Legal Business Name): OCEANVIEW PAIN TREATMENT MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 ELM AVE # 216
LONG BEACH CA
90806-1651
US

IV. Provider business mailing address

4543 E ANAHEIM ST
LONG BEACH CA
90804-3119
US

V. Phone/Fax

Practice location:
  • Phone: 562-424-2900
  • Fax: 562-424-3200
Mailing address:
  • Phone: 562-900-1371
  • Fax: 562-494-0047

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: MS. ELAINE W. HUTCHISON
Title or Position: ADMINISTRATOR
Credential:
Phone: 562-900-1371