MEDICARE: ROBERT ALAN NAGOURNEY M.D.

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	174400000X	Specialist	G43463	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285694018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT ALAN NAGOURNEY M.D.

Provider Business Mailing Address
First Line	:	701 E 28TH ST
Second Line	:	STE 418
City	:	LONG BEACH
State	:	CA
Zip	:	90806-2759
Country	:	US
Telephone Number	:	562-989-6455
Fax Number	:	562-989-8160

Provider Business Practice Location Address
First Line	:	701 E 28TH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-2759
Country	:	US
Telephone Number	:	562-989-6455
Fax Number	:	562-989-8160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	01/14/2013

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