Healthcare Provider Details

I. General information

NPI: 1407486905
Provider Name (Legal Business Name): INTEGRATIVE PHYSICAL MEDICINE PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 ELM AVE STE 210
LONG BEACH CA
90806-1600
US

IV. Provider business mailing address

9080 IRVINE CENTER DR
IRVINE CA
92618-4658
US

V. Phone/Fax

Practice location:
  • Phone: 833-476-7377
  • Fax:
Mailing address:
  • Phone: 833-476-7377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: HEZHONG QI
Title or Position: DIRECTOR OF CLINIC OPERATIONS
Credential:
Phone: 833-476-7377