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NPI Code Detail

MEDICARE: LONG BEACH PAIN CENTER & MEDICAL CLINIC

MEDICARE: LONG BEACH PAIN CENTER & MEDICAL CLINIC
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
1261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1154310753
Entity Type Code : Organization
Provider Name (Legal Business Name) : LONG BEACH PAIN CENTER & MEDICAL CLINIC
Provider Business Mailing Address
First Line : 2760 PACIFIC AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-2613
Country : US
Telephone Number : 562-427-7100
Fax Number :
Provider Business Practice Location Address
First Line : 2760 PACIFIC AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-2613
Country : US
Telephone Number : 562-427-7100
Fax Number :
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : JUDY HOPKINS
Credential : RN
Telephone Number : 562-446-2229
Provider Enumeration Date : 10/17/2005
Last Update Date : 08/22/2020

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Directions to “LONG BEACH PAIN CENTER & MEDICAL CLINIC ” Practice Location

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