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General NPI Number Information
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NPI Number | 1003829722
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Entity Type | Organization
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Legal Business Name | LONG BEACH MEMORIAL MEDICAL
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 2801 ATLANTIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90806
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Country | US
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Telephone | 562-933-0330
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Fax | 562-933-2014
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Provider Business Mailing Address
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Address Line | PO BOX 20359
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City | LONG BEACH
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State | CA
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Zip | 90801-3359
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Country | US
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Telephone | 562-933-0273
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Fax | 562-933-1794
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | CHRIS FINCH
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Credential |
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Telephone | 714-377-3218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY22489
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License Number State | CA
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