Healthcare Provider Details

I. General information

NPI: 1811816119
Provider Name (Legal Business Name): LOREN KNIGHT CLIFFORD LOREN KNIGHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 ATLANTIC AVE # 1187
LONG BEACH CA
90807-4515
US

IV. Provider business mailing address

3515 ATLANTIC AVE # 1187
LONG BEACH CA
90807-4515
US

V. Phone/Fax

Practice location:
  • Phone: 562-200-9584
  • Fax: 562-200-9584
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: