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General NPI Number Information
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NPI Number | 1235220732
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Entity Type | Organization
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Legal Business Name | VA LONG BEACH HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11441 MARTHA ANN DR
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3807
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Country | US
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Telephone | 562-598-0654
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Fax |
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Provider Business Mailing Address
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Address Line | 5901 E 7TH ST
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City | LONG BEACH
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State | CA
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Zip | 90822-5201
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Country | US
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Telephone | 562-826-8000
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Fax |
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Authorized Official
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Title or Position | REGISTERED RESPIRATORY THERAPIST
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Name | DIANE HUNTINGTON
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Credential | R.R.T.
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Telephone | 562-826-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 00000953
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License Number State | CA
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