MEDICARE: CITY OF LONG BEACH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP0905X	State or Local Public Health Clinic/Center
2	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1083638530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF LONG BEACH

Provider Business Mailing Address
First Line	:	2525 GRAND AVE
Second Line	:	ROOM #260
City	:	LONG BEACH
State	:	CA
Zip	:	90815-1765
Country	:	US
Telephone Number	:	562-570-4075
Fax Number	:	562-570-4070

Provider Business Practice Location Address
First Line	:	2525 GRAND AVE
Second Line	:	ROOM #260
City	:	LONG BEACH
State	:	CA
Zip	:	90815-1765
Country	:	US
Telephone Number	:	562-570-4075
Fax Number	:	562-570-4070

Authorized Official
Title or Position	:	HEALTH OFFICER
Name	:	ANISSA DANIELLE DAVIS
Credential	:	MD
Telephone Number	:	562-570-4047

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	11/13/2024

Similar Medicare Providers

1780326835 — DR. SHERRY REDDIX MD, MA, MPH
Practice Location Address:

2525 GRAND AVE STE 167
LONG BEACH, CA
90815-1765

Practice Phone: 562-570-4526
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1982090858 — CLIFF OKADA MD
Practice Location Address:

2525 GRAND AVE
LONG BEACH, CA
90815-1765

Practice Phone: 562-570-4000
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1144222803 — DR. MAURO S TORNO M.D.
Practice Location Address:

2525 GRAND AVE
LONG BEACH, CA
90815-1765

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Practice Fax: 562-570-4033

1922141936 — DEBORAH OWENS COLLINS PA
Practice Location Address:

2525 GRAND AVE , STE 106
LONG BEACH, CA
90815-1765

Practice Phone: 562-570-4379
Practice Fax:

1265576755 — MRS. JENNIFER JANE BACKER MSN, FNP
Practice Location Address:

2525 GRAND AVE , ROOM 106
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90815-1765

Practice Phone: 562-570-4056
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1477698520 — NANCY RIANO NURSE PRACTITIONER
Practice Location Address:

2525 GRAND AVE , ROOM 106
LONG BEACH, CA
90815-1765

Practice Phone: 562-570-4254
Practice Fax: 562-570-4039

Directions to “CITY OF LONG BEACH ” Practice Location

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