Healthcare Provider Details

I. General information

NPI: 1487501326
Provider Name (Legal Business Name): CAROLINE DWYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13210 FLORENCE AVE
SANTA FE SPRINGS CA
90670-4510
US

IV. Provider business mailing address

1250 E 6TH ST
LONG BEACH CA
90802-1705
US

V. Phone/Fax

Practice location:
  • Phone: 562-574-2637
  • Fax:
Mailing address:
  • Phone: 562-673-5820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: