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General NPI Number Information
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NPI Number | 1063870103
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Entity Type | Organization
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Legal Business Name | MY TRUE HEALTH CENTER CARE INC
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 02/03/2016
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Provider Practice Location Address
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Address Line | 3939 ATLANTIC AVE SUITE 100
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City | LONG BEACH
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State | CA
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Zip | 90807-3536
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Country | US
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Telephone | 562-457-6010
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Fax | 562-424-5600
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Provider Business Mailing Address
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Address Line | 3939 ATLANTIC AVE SUITE 100
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City | LONG BEACH
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State | CA
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Zip | 90807-3536
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Country | US
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Telephone | 562-457-6010
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Fax | 562-424-5600
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Authorized Official
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Title or Position | COO
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Name | MS. EBONY DIANE FOSTER
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Credential |
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Telephone | 562-457-6010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A30496
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License Number State | CA
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