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General NPI Number Information
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NPI Number | 1841233624
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Entity Type | Organization
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Legal Business Name | DOUGLAS K ULMER MD, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 1045 ATLANTIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90813-3408
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Country | US
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Telephone | 562-435-5621
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Fax | 562-437-3121
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Provider Business Mailing Address
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Address Line | 1045 ATLANTIC AVE 819
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City | LONG BEACH
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State | CA
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Zip | 90813-3408
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Country | US
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Telephone | 562-435-5621
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DOUGLAS ULMER
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Credential |
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Telephone | 562-435-5621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | A24825
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License Number State | CA
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