Healthcare Provider Details

I. General information

NPI: 1053351155
Provider Name (Legal Business Name): LONG BEACH MEMORIAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 ATLANTIC AVE
LONG BEACH CA
90806
US

IV. Provider business mailing address

2801 ATLANTIC AVE
LONG BEACH CA
90806-1737
US

V. Phone/Fax

Practice location:
  • Phone: 562-933-2000
  • Fax: 562-933-1107
Mailing address:
  • Phone: 562-933-2000
  • Fax: 562-933-1107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number93000102
License Number StateCA

VIII. Authorized Official

Name: CHRIS FINCH
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 714-377-3218