Healthcare Provider Details

I. General information

NPI: 1831373232
Provider Name (Legal Business Name): LONG BEACH DEPARTMENT HEALTH AND HUMAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2007
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 GRAND AVE
LONG BEACH CA
90815-1765
US

IV. Provider business mailing address

2525 GRAND AVE
LONG BEACH CA
90815-1765
US

V. Phone/Fax

Practice location:
  • Phone: 562-570-4247
  • Fax: 562-570-4099
Mailing address:
  • Phone: 562-570-4247
  • Fax: 562-570-4099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number669332
License Number StateCA

VIII. Authorized Official

Name: MRS. PERPETUA E OKOH
Title or Position: PUBLIC HEALTH NURSE
Credential:
Phone: 562-570-4247