MEDICARE: FRESENIUS MEDICAL CARE LONG BEACH, LLC

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	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center		CA

General Provider Information

NPI Number	:	1497120182
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRESENIUS MEDICAL CARE LONG BEACH, LLC

Provider Business Mailing Address
First Line	:	1525 LONG BEACH BLVD
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-1923
Country	:	US
Telephone Number	:	562-283-6195
Fax Number	:	323-374-5541

Provider Business Practice Location Address
First Line	:	1525 LONG BEACH BLVD
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-1923
Country	:	US
Telephone Number	:	562-283-6195
Fax Number	:	323-374-5541

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	BARRY L. BLANTON
Credential	:
Telephone Number	:	781-699-9000

Provider Enumeration Date	:	12/07/2015
Last Update Date	:	10/12/2023

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