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General NPI Number Information
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NPI Number | 1255668976
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Entity Type | Organization
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Legal Business Name | ALAMITOS BEACH CITIES PODIATRY GROUP
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 304 CHERRY AVE
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City | LONG BEACH
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State | CA
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Zip | 90802-3848
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Country | US
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Telephone | 562-496-3846
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Fax | 562-438-3690
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Provider Business Mailing Address
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Address Line | 304 CHERRY AVE
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City | LONG BEACH
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State | CA
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Zip | 90802-3848
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Country | US
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Telephone | 562-496-3846
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Fax | 562-438-3690
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Authorized Official
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Title or Position | COO
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Name | DR. MIE SHIRAI
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Credential | DPM
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Telephone | 562-496-3846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4826
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License Number State | CA
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