MEDICARE: LONG BEACH MEMORIAL MEDICAL CENTER

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	251G00000X	Community Based Hospice Care Agency	980000516	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942240007
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LONG BEACH MEMORIAL MEDICAL CENTER

Provider Business Mailing Address
First Line	:	2801 ATLANTIC AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-1737
Country	:	US
Telephone Number	:	562-933-2000
Fax Number	:	562-933-1107

Provider Business Practice Location Address
First Line	:	695 E 27TH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90755
Country	:	US
Telephone Number	:	562-933-4663
Fax Number	:	562-933-0995

Authorized Official
Title or Position	:	CHIEF COMPLIANCE OFFICER
Name	:	CHRIS FINCH
Credential	:
Telephone Number	:	714-377-3218

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	08/23/2018

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Directions to “LONG BEACH MEMORIAL MEDICAL CENTER ” Practice Location

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