Healthcare Provider Details

I. General information

NPI: 1134342041
Provider Name (Legal Business Name): MILAGROS FERRARIZ DEMANDANTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 12/23/2020
Certification Date: 12/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4510 E. PACIFIC COAST HIGHWAY SUITE 600
LONG BEACH CA
90804
US

IV. Provider business mailing address

4510 E PACIFIC COAST HIGHWAY SUITE 600
LONG BEACH CA
90804
US

V. Phone/Fax

Practice location:
  • Phone: 562-346-1100
  • Fax:
Mailing address:
  • Phone: 562-346-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberA90143
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA90143
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberA91043
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: