Healthcare Provider Details

I. General information

NPI: 1497712012
Provider Name (Legal Business Name): HELENA CHARLETTE HUMPHREY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2699 ATLANTIC AVE
LONG BEACH CA
90806-2710
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 562-426-3333
  • Fax:
Mailing address:
  • Phone: 702-579-3203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG56018
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: