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NPI Code Detail

MEDICARE: MS. ILENE RETH

MEDICARE: MS. ILENE RETH
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
1171M00000XCase Manager/Care Coordinator
2172V00000XCommunity Health Worker
3225400000XRehabilitation Practitioner
4373H00000XDay Training/Habilitation SpecialistCA

General Provider Information

NPI Number : 1902973381
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ILENE RETH
Provider Business Mailing Address
First Line : 4510 E PACIFIC COAST HWY STE 600
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-6914
Country : US
Telephone Number : 562-346-1100
Fax Number :
Provider Business Practice Location Address
First Line : 4510 E PACIFIC COAST HWY STE 600
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-6914
Country : US
Telephone Number : 562-346-1100
Fax Number : 562-685-0867
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2006
Last Update Date : 06/27/2025

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