MEDICARE: HOWARD LESTER WORCESTER 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	207R00000X	Internal Medicine Physician	G23356	CA

General Provider Information

NPI Number	:	1689696585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD LESTER WORCESTER M.D.

Provider Business Mailing Address
First Line	:	2650 ELM AVE
Second Line	:	#309
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1651
Country	:	US
Telephone Number	:	562-595-8549
Fax Number	:	562-427-6271

Provider Business Practice Location Address
First Line	:	2650 ELM AVE
Second Line	:	#309
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1651
Country	:	US
Telephone Number	:	562-595-8549
Fax Number	:	562-427-6271

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

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	07/08/2007

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