IGENOME, INC. (NPI# 1770102105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770102105 |
| Entity Type | Organization |
| Organization Name | IGENOME, INC. |
| Other Organization Name | IGENOME CANCER INSTITUTE |
| Practice Address |
1 World Trade Ctr Fl 8 Long Beach CA 90831-0002 |
| Mailing Address |
1835 Chestnut St Apt 3r Philadelphia PA 19103-3702 |
| Practice Telephone | 2678962176 |
| Mailing Telephone | 2678962176 |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2020-04-20 |
| Authorized Official Name | YU SONG (CEO) |
| Authorized Official Telephone | 2678962176 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | PENDING | 05 | |
| CA | MEDICAID | PENDING | 01 |
| NY | PENDING | 05 | |
| MA | PENDING | 05 | |
| NJ | PENDING | 05 |
| Other Name | Type Code |
|---|---|
| iGENOME CANCER INSTITUTE | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1640 Newport Blvd Ste 445, Costa Mesa, CA 926277730 | 2678962176 | |
| 1835 Chestnut St Apt 3r, Philadelphia, PA 191033702 | 2678962176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689294241 | Igenome, Inc. | Clinical Medical Laboratory | 1 World Trade Ctr Fl 8, Long Beach, CA 90831-0002 | 2020-04-23 |
| 1871113431 | Igenome, Inc. | Medical Genetics | 1 World Trade Ctr Fl 8, Long Beach, CA 90831-0002 | 2020-04-23 |
| 1104446798 | Igenome, Inc. | Pharmacy | 1 World Trade Ctr Fl 8, Long Beach, CA 90831-0002 | 2020-04-23 |
| Street Address |
1 WORLD TRADE CTR FL 8 |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90831-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538498548 | Yu Song | Pharmacist | 1 World Trade Ctr Fl 8, Long Beach, CA 90831-0002 | 2009-12-22 |
| 1689294241 | Igenome, Inc. | Clinical Medical Laboratory | 1 World Trade Ctr Fl 8, Long Beach, CA 90831-0002 | 2020-04-23 |
| 1871113431 | Igenome, Inc. | Medical Genetics | 1 World Trade Ctr Fl 8, Long Beach, CA 90831-0002 | 2020-04-23 |
| 1104446798 | Igenome, Inc. | Pharmacy | 1 World Trade Ctr Fl 8, Long Beach, CA 90831-0002 | 2020-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366683096 | Lvn/inhome Care Nursing | Private Vehicle | 1 World Trade Ctr, Suite 800, Long Beach, CA 90831-0002 | 2009-03-09 |
| 1023430717 | Providence Community Services | Social Worker | 1 World Trade Ctr, 8th. Floor, Long Beach, CA 90831-0002 | 2014-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073114807 | The Healing Sanctum-greenmeadow, LLC | Skilled Nursing Facility | 5302 E Greenmeadow Rd, Long Beach, CA 90808-1620 | 2020-11-06 |
| 1215538590 | Ramsha Khan | Behavior Technician | 225 W 3rd St Apt 436, Long Beach, CA 90802-3052 | 2020-11-04 |
| 1053911842 | Michael Guerret | Optometrist | 4130 N Viking Way # 110, Long Beach, CA 90808-1402 | 2020-10-29 |
| 1053911412 | Blue Ivory and Palliative Care, Inc | Home Infusion | 2777 Pacific Ave Ste 2k, Long Beach, CA 90806-2625 | 2020-10-27 |
| 1821697434 | Global Regency Senior Care Services, LLC | Assisted Living Facility | 117 E 8th St, Long Beach, CA 90813-4397 | 2020-10-23 |
| 1568061117 | Charisse Christie Magsaysay | Nurse Practitioner | 4508 Atlantic Ave Ste 468a, Long Beach, CA 90807-1520 | 2020-10-23 |
| 1578162343 | Shanna Rae Parker | Massage Therapist | 4226 E 4th St Apt 1, Long Beach, CA 90814-4927 | 2020-10-22 |
| 1427657519 | Alana B. Williams | Social Worker | 527 Mockingbird Dr, Long Beach, MS 39560-3118 | 2020-10-20 |
| 1578162616 | Bayfront Healthcare Services | Community/Behavioral Health | 2703 N Studebaker Rd, Long Beach, CA 90815-1628 | 2020-10-20 |
| 1376142430 | Daria Mohazzab Hosseinian | Pharmacist | 450 E Spring St Ste 11, Long Beach, CA 90806-1625 | 2020-10-20 |
| Find all providers in LONG BEACH | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104023514 | Antonio Beltran | Internal Medicine | 3605 Long Beach Blvd Ste 405, Long Beach, CA 90807-4026 | 2007-06-29 |
| 1407989247 | James D. Leo, M.d., Inc. | Internal Medicine | 2650 Elm Ave Ste 307, Long Beach, CA 90806-1600 | 2007-03-13 |
| 1366503344 | Rajeshri P. Patel | Internal Medicine | 430 E Bay Dr, Long Beach, NY 11561-2351 | 2006-12-13 |
| 1376634501 | George Huthsteiner II | Internal Medicine | 2600 Redondo Ave Ste 400, Long Beach, CA 90806-2330 | 2006-09-26 |
| 1053643700 | Mohamed Elnaggar | Internal Medicine | 3605 Long Beach Blvd Ste 405, Long Beach, CA 90807-4026 | 2010-02-05 |
| 1417191990 | Diane L. Johnson M.d. Inc | Internal Medicine | 65 Pine Ave, Suite 19, Long Beach, CA 90802-4718 | 2009-04-28 |
| 1174749246 | Pulmonary and Critical Care Consultants Inc | Internal Medicine | 2600 Redondo Ave Ste 400, Long Beach, CA 90806-2330 | 2007-04-17 |
| 1881700516 | Catherine Sassoon | Internal Medicine | 5901 E 7th St, Long Beach, CA 90822-5201 | 2006-08-23 |
| 1023026838 | James Norman Logan | Internal Medicine | 2699 Atlantic Ave, Long Beach, CA 90806-2710 | 2006-08-04 |
| 1568430098 | Deborah Helen Milligan | Internal Medicine | 2699 Atlantic Ave, Long Beach, CA 90806-2710 | 2006-03-10 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90831 |
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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.