Healthcare Provider Details

I. General information

NPI: 1558346775
Provider Name (Legal Business Name): CITY OF LONG BEACH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 W OCEAN BLVD LBBY
LONG BEACH CA
90802-4511
US

IV. Provider business mailing address

411 W OCEAN BLVD LBBY
LONG BEACH CA
90802-4511
US

V. Phone/Fax

Practice location:
  • Phone: 562-570-7600
  • Fax: 562-570-6783
Mailing address:
  • Phone: 562-570-7600
  • Fax: 562-570-6783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: DIANA AMBRIZ
Title or Position: FINANCIAL SERVICES OFFICER
Credential:
Phone: 562-570-7109