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NPI Code Detail

MEDICARE: LIVE WELL - FAMILY MEDICINE CENTER OF NAPLES, INC.

MEDICARE: LIVE WELL - FAMILY MEDICINE CENTER OF NAPLES, INC.
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
1261QP2300XPrimary Care Clinic/CenterA063555CA

General Provider Information

NPI Number : 1316158520
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIVE WELL - FAMILY MEDICINE CENTER OF NAPLES, INC.
Provider Business Mailing Address
First Line : PO BOX 828
Second Line :
City : LOS ALAMITOS
State : CA
Zip : 90720-0828
Country : US
Telephone Number : 562-434-7777
Fax Number :
Provider Business Practice Location Address
First Line : 4910 AIRPORT PLAZA DR STE 100
Second Line :
City : LONG BEACH
State : CA
Zip : 90815-1377
Country : US
Telephone Number : 562-434-7777
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DAVID SHEN
Credential : M.D.
Telephone Number : 714-504-9053
Provider Enumeration Date : 05/28/2007
Last Update Date : 10/26/2020

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Directions to “LIVE WELL - FAMILY MEDICINE CENTER OF NAPLES, INC. ” Practice Location

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