Healthcare Provider Details

I. General information

NPI: 1467411744
Provider Name (Legal Business Name): JOHN PAUL CARDIN JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 05/21/2021
Certification Date: 05/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 ATLANTIC AVE SUITE 230
LONG BEACH CA
90806-1735
US

IV. Provider business mailing address

2880 ATLANTIC AVE SUITE 230
LONG BEACH CA
90806-1714
US

V. Phone/Fax

Practice location:
  • Phone: 562-424-4404
  • Fax: 562-424-5180
Mailing address:
  • Phone: 562-424-4404
  • Fax: 562-424-5180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberA41250
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA41250
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA41250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: