LONG BEACH GASTROENTEROLOGY, INC. (NPI# 1003829797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003829797 |
| Entity Type | Organization |
| Organization Name | LONG BEACH GASTROENTEROLOGY, INC. |
| Other Organization Name | LONG BEACH GASTROENTEROLOGY ASSOCIATES |
| Practice Address |
3833 Worsham Ave Suite 300 Long Beach CA 90808-1745 |
| Mailing Address |
3833 Worsham Ave Ste 300 Long Beach CA 90808-1766 |
| Practice Telephone | 5625955421 |
| Practice Fax Number | 5624262862 |
| Mailing Telephone | 5625955421 |
| Mailing Fax Number | 5624262862 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2018-10-16 |
| Authorized Official Name | ELIZABETH USIS-PRADO (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 5625955421 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0058960 | 05 |
| Other Name | Type Code |
|---|---|
| Long Beach Gastroenterology Associates | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7677 Center Ave Ste 201, Huntington Beach, CA 926473074 | 5629974545 | 5624262862 |
| Street Address |
3833 WORSHAM AVE SUITE 300 |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90808-1745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558716704 | Kaitlin Elizabeth Kilian | Nurse Practitioner | 3833 Worsham Ave, Suite 300, Long Beach, CA 90808-1745 | 2016-04-25 |
| 1932466125 | Jose Luis Aranez | Internal Medicine | 3833 Worsham Ave, Long Beach, CA 90808-1745 | 2012-04-12 |
| 1265700694 | Ann Wang | Nurse Practitioner | 3833 Worsham Ave, Suite 300, Long Beach, CA 90808-1745 | 2011-12-13 |
| 1831489095 | Rachna M Shah | Physician Assistant | 3833 Worsham Ave, Suite 300, Long Beach, CA 90808-1745 | 2011-04-08 |
| 1861799496 | Janet Chou | Pediatrics | 3833 Worsham Ave, Suite 301, Long Beach, CA 90808-1745 | 2011-02-16 |
| 1942373014 | Janet P Mccormick | Pediatrics | 3833 Worsham Ave, Suite 301, Long Beach, CA 90808-1745 | 2006-11-16 |
| 1275606261 | Eric B Lau | Pediatrics | 3833 Worsham Ave, Suite 301, Long Beach, CA 90808-1745 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629558713 | Long Beach-lakewood Orthopedic Institute | Orthopaedic Surgery | 3828 Schaufele Ave Ste 320, Long Beach, CA 90808 | 2018-08-17 |
| 1376072710 | Premiere Cottages Inc. | Assisted Living Facility | 4815 Premiere Ave, Long Beach, CA 90808 | 2017-06-08 |
| 1760911184 | Collaborative Partners for Success, LLC | Speech-Language Pathologist | 3472 Tulane Avenue, Long Beach, CA 90808 | 2017-06-08 |
| 1942658604 | Susan S Orr | Physical Therapist | 3833 Worsham Ave #301, Long Beach, CA 90808 | 2016-06-02 |
| 1447611298 | Rac Brittany House | Alzheimer Center (Dementia Center) | 5641 Centralia Avenue, Long Beach, CA 90808 | 2016-03-08 |
| 1003234261 | Ray Ira Apter | Social Worker | 4333 N. Greenbrier Road, Long Beach, CA 90808 | 2014-04-03 |
| 1043590649 | Fonda Jiang | Allergy & Immunology | 3816 Woodruff Ave Ste 209, Long Beach, CA 90808 | 2011-08-26 |
| 1457640757 | Alexander Cristian Gavrila | Dentist | 4200 Lakewood Blvd, Long Beach, CA 90808 | 2011-04-07 |
| 1851629034 | Reyana Ewing | Dietitian, Registered | 4195 N Viking Way Ste D, Long Beach, CA 90808 | 2009-11-25 |
| 1548497597 | Veronika Lee Hoover | Social Worker | 4195 N. Viking Way, Suite F, Long Beach, CA 90808 | 2009-06-17 |
| Find all providers in zip 90808 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790323681 | Samantha Dylan Schustek | Specialist | 414 E Chester St, Long Beach, NY 11561-2304 | 2019-12-11 |
| 1780234914 | Esther Maria Salorio | Specialist | 26 W Broadway Apt 603, Long Beach, NY 11561-4063 | 2019-09-19 |
| 1043867740 | Elizabeth Fichtelman | Specialist | 513 E Fulton St, Long Beach, NY 11561-2416 | 2019-08-19 |
| 1245886340 | Jennifer Kolonkowski | Specialist | 450 Shore Rd Apt 4m, Long Beach, NY 11561-5335 | 2019-08-14 |
| 1700431293 | Amy L Eisenberg | Specialist | 666 Shore Rd Apt 6m, Long Beach, NY 11561-4616 | 2019-08-02 |
| 1063948081 | Helene Rodway | Specialist | 360 Shore Rd Apt 10h, Long Beach, NY 11561-4381 | 2017-05-11 |
| 1053866699 | Breanne Day | Specialist | 65 W Broadway Apt 10g, Long Beach, NY 11561-4021 | 2016-08-24 |
| 1205286101 | Wendina Mon Pech | Specialist | 1050 E 17th St, Long Beach, CA 90813-2110 | 2016-06-21 |
| 1457708596 | Maggie Aline Lanctot | Specialist | 1906 E 1st St, 4b, Long Beach, CA 90802-6109 | 2016-05-18 |
| 1740635697 | Elizabeth Judith Cantwell | Specialist | 700 Shore Rd Apt 6a, Long Beach, NY 11561-4718 | 2016-04-28 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90808 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.