Healthcare Provider Details

I. General information

NPI: 1841200847
Provider Name (Legal Business Name): MEMORIAL PULMONARY & SLEEP CONSULTANTS A MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 01/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E 28TH ST STE 318
LONG BEACH CA
90806-2785
US

IV. Provider business mailing address

701 E 28TH ST STE 318
LONG BEACH CA
90806-2785
US

V. Phone/Fax

Practice location:
  • Phone: 562-290-8888
  • Fax:
Mailing address:
  • Phone: 562-290-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License NumberA53904
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA53904
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberG28692
License Number StateCA

VIII. Authorized Official

Name: DR. STEPHEN EDWARD BROWN
Title or Position: DIRECTOR
Credential: M.D.
Phone: 562-290-8888