MEDICARE: CAROL ELIZABETH BELL IBCLC

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	174N00000X	Lactation Consultant (Non-RN)	L-302384	CA

General Provider Information

NPI Number	:	1619566288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL ELIZABETH BELL IBCLC

Provider Business Mailing Address
First Line	:	1923 E WASHINGTON ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-5538
Country	:	US
Telephone Number	:	562-773-9524
Fax Number	:

Provider Business Practice Location Address
First Line	:	1923 E WASHINGTON ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90805-5538
Country	:	US
Telephone Number	:	562-773-9524
Fax Number	:

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

Provider Enumeration Date	:	01/18/2021
Last Update Date	:	01/18/2021

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