LONG BEACH SURGICAL GROUP A MEDICAL CORPORATION (NPI# 1073795498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073795498 |
| Entity Type | Organization |
| Organization Name | LONG BEACH SURGICAL GROUP A MEDICAL CORPORATION |
| Practice Address |
1040 Elm Ave Suite #303 Long Beach CA 90813-3264 |
| Practice Telephone | 5624369645 |
| Practice Fax Number | 5624367119 |
| Mailing Telephone | 5624369645 |
| Mailing Fax Number | 5624367119 |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2012-10-05 |
| Authorized Official Name | MS. LINDA ROSE (OFFICE MANAGER) |
| Authorized Official Telephone | 5624369645 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | C25484 | CA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00C254840 | 05 | |
| CA | GR0014610 | 05 |
| Street Address |
1040 ELM AVE SUITE #303 |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90813-3264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891770970 | Tanya De La Cerda | Physical Therapist | 1040 Elm Ave, Suite #100, Long Beach, CA 90813-3264 | 2005-12-12 |
| 1558812990 | United Medical Radiology Network, Inc. | Clinic/Center | 1040 Elm Ave, Suite 102, Long Beach, CA 90813-3264 | 2016-10-20 |
| 1265982359 | Prohealth Partners A Medical Group | Surgery | 1040 Elm Ave, Suite 100, Long Beach, CA 90813-3264 | 2016-10-12 |
| 1780031211 | United Medical Imaging Healthcare, Inc. | Clinic/Center | 1040 Elm Ave, Suite 102, Long Beach, CA 90813-3264 | 2016-05-13 |
| 1285028209 | Solomon Care M.d., Inc., A Professional Corporation | Nurse Practitioner | 1040 Elm Ave, Suite 304, Long Beach, CA 90813-3264 | 2015-03-27 |
| 1588056063 | Lena Kuang | Nurse Practitioner | 1040 Elm Ave, Long Beach, CA 90813-3264 | 2015-02-20 |
| 1811334071 | Nationwide Drug and Alcohol Counseling,inc. | Counselor | 1040 Elm Ave, 310, Long Beach, CA 90813-3264 | 2013-05-29 |
| 1063664514 | Faustino Bernadett Jr Md Inc A Professional Medical Corporation | Specialist | 1040 Elm Ave, 100, Long Beach, CA 90813-3264 | 2008-10-15 |
| 1467647511 | Lyman Kennedy Jr. | Physical Therapist | 1040 Elm Ave, Suite #100, Long Beach, CA 90813-3264 | 2007-09-12 |
| 1851507099 | Robert W Driscoll | Specialist | 1040 Elm Ave, Suite #100, Long Beach, CA 90813-3264 | 2007-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861018491 | Marisol Zobler | Social Worker | 820 Long Beach Bvld, Long Beach, CA 90813 | 2020-06-19 |
| 1437787009 | Cho Rok Kim | Student in an Organized Health Care Education/Training Program | Graduate Medical Education, 1050 Linden Ave., Long Beach, CA 90813 | 2020-03-30 |
| 1316407596 | Vicky Sandhu | Student in an Organized Health Care Education/Training Program | Graduate Medical Education, 1050 Linden Ave, Long Beach, CA 90813 | 2019-03-22 |
| 1245734912 | Madiha Naseem | Internal Medicine | Graduate Medical Education, 1050 Linden Avenue, Long Beach, CA 90813 | 2018-03-19 |
| 1689194508 | Naomi Ruiz | Specialist/Technologist | 838 Pine Ave Apt. 314, Long Beach, CA 90813 | 2017-06-21 |
| 1851831531 | Tyler Lappen | Student in an Organized Health Care Education/Training Program | 830 Atlantic Ave., Long Beach, CA 90813 | 2017-03-01 |
| 1639628886 | Assavuth Kim | Community Health Worker | 1471 Cherry Avenue, Long Beach, CA 90813 | 2016-09-29 |
| 1881031300 | Stacy Nicole Delgado-willis | Marriage & Family Therapist | 851 Pine Ave Ste 103, Long Beach, CA 90813 | 2013-05-23 |
| 1740623453 | Paula Ann Di Thomas | Nurse Practitioner | 1043 Elm Ave #104, Long Beach, CA 90813 | 2013-04-11 |
| 1629322722 | David O Chavez | Case Manager/Care Coordinator | 820 Long Beach Blvd, Long Beach, CA 90813 | 2012-10-29 |
| Find all providers in zip 90813 | ||||
| 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 | 90813 |
Please comment or provide details below to improve the information on LONG BEACH SURGICAL GROUP A MEDICAL CORPORATION.
| 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.