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General NPI Number Information
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NPI Number | 1841865409
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Entity Type | Organization
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Legal Business Name | MEMORIALCARE OCCUPATIONAL MEDICINE
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Dates
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Enumeration Date | 05/25/2021
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 2110 N BELLFLOWER BLVD
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City | LONG BEACH
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State | CA
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Zip | 90815-3126
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Country | US
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Telephone | 714-377-3218
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Fax |
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Provider Business Mailing Address
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Address Line | 17360 BROOKHURST ST
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-3720
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Country | US
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Telephone | 714-377-3218
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Fax | 714-377-3225
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | CHRIS FINCH
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Credential |
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Telephone | 714-377-3218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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