Healthcare Provider Details

I. General information

NPI: 1548686348
Provider Name (Legal Business Name): PACIFIC WELLNESS CLINIC ISEKE BELTRAN INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2014
Last Update Date: 03/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 LONG BEACH BLVD STE 1018
LONG BEACH CA
90807-3678
US

IV. Provider business mailing address

3711 LONG BEACH BLVD STE 1018
LONG BEACH CA
90807-3678
US

V. Phone/Fax

Practice location:
  • Phone: 562-426-2244
  • Fax:
Mailing address:
  • Phone: 562-426-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License NumberDC30855
License Number StateCA

VIII. Authorized Official

Name: DR. HAROLD ISEKE II
Title or Position: CEO
Credential: DC
Phone: 562-426-2244