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General NPI Number Information
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NPI Number | 1164033684
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Entity Type | Organization
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Legal Business Name | FIRST CARE MULTISPECIALTY MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 4401 ATLANTIC AVE STE 480
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City | LONG BEACH
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State | CA
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Zip | 90807-2265
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Country | US
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Telephone | 562-595-5424
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Fax |
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Provider Business Mailing Address
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Address Line | 4401 ATLANTIC AVE STE 480
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City | LONG BEACH
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State | CA
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Zip | 90807-2265
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | LISA MONTAGUE
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Credential | JD
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Telephone | 310-203-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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