MEDICARE: OCEANVIEW PAIN TREATMENT MEDICAL CENTER, 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
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1669475570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEANVIEW PAIN TREATMENT MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	4543 E ANAHEIM ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-3119
Country	:	US
Telephone Number	:	562-900-1371
Fax Number	:	562-494-0047

Provider Business Practice Location Address
First Line	:	2650 ELM AVE
Second Line	:	# 216
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1651
Country	:	US
Telephone Number	:	562-424-2900
Fax Number	:	562-424-3200

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. ELAINE W. HUTCHISON
Credential	:
Telephone Number	:	562-900-1371

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/19/2023

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