ELDER AUDIO REHAB MEDICAL GROUP INC (NPI# 1871743856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871743856 |
| Entity Type | Organization |
| Organization Name | ELDER AUDIO REHAB MEDICAL GROUP INC |
| Practice Address |
4029 E Anaheim St Long Beach CA 90804-4110 |
| Mailing Address |
65 Pine Ave Suite 119 Long Beach CA 90802-4718 |
| Practice Telephone | 5624944421 |
| Practice Fax Number | 5624942731 |
| Mailing Telephone | 5627608823 |
| Mailing Fax Number | 5622529505 |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2011-02-18 |
| Authorized Official Name | MR. MARSHALL EDWARD BLESOFSKY (PROVIDER/COO) |
| Authorized Official Telephone | 5627608823 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| Y | 363A00000X | Physician Assistant | FNP37597 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4029 E ANAHEIM ST |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90804-4110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811996507 | Rose Park Healthcare Associates,inc. | Skilled Nursing Facility | 4029 E Anaheim St, Long Beach, CA 90804-4110 | 2005-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821616673 | Exporter Medical LLC | Durable Medical Equipment & Medical Supplies | 2990 E. Pacific Coast Hwy., Suite B, Long Beach, CA 90804 | 2020-07-08 |
| 1700436094 | Magdalema Ballesteros-reynolds | Technician | 844 Ohio Ave, Long Beach, CA 90804 | 2019-09-18 |
| 1093365447 | Edelmira D Sanchez | Technician | 837 Bennett Ave, Long Beach, CA 90804 | 2019-09-18 |
| 1164980165 | Carlton Fortenberry | Behavior Technician | 775 Obispo Ave., Unit 1, Long Beach, CA 90804 | 2019-03-08 |
| 1427522812 | Western Dental Services, Inc. | Dentist | 2306 E 7th Street, Long Beach, CA 90804 | 2019-01-18 |
| 1124557657 | Keav Siv Khov | Social Worker | 4510 East Pacific Coast Highway, Suite 600, Long Beach, CA 90804 | 2017-06-08 |
| 1265966576 | Kensie Hoag | Social Worker | 4510 E PCh, Suite 305, Long Beach, CA 90804 | 2017-04-13 |
| 1528424389 | Rem Pacific Sleep Center, Inc. | Specialist/Technologist | 2990 E. Pacific Coast Hwy, Suite A, Long Beach, CA 90804 | 2016-01-10 |
| 1417326935 | Kelli Ann Carlson | Student in an Organized Health Care Education/Training Program | 2025 E. 7th Street, Long Beach, CA 90804 | 2015-09-15 |
| 1487059010 | Kenenth K. Lee, D.d.s., Inc. | Preferred Provider Organization | 4755 E. Anaheim St., Long Beach, CA 90804 | 2014-10-24 |
| Find all providers in zip 90804 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831703958 | Melanie Layne Mccoy | Physician Assistant | 202 Joyce Ave, Long Beach, MS 39560-4332 | 2020-09-04 |
| 1285244525 | Amir Kamal Abdou | Physician Assistant | 133 The Promenade N Unit 112, Long Beach, CA 90802-4728 | 2020-08-02 |
| 1316564156 | Eva Dolores Larson | Physician Assistant | 2230 Knoxville Ave, Long Beach, CA 90815-2340 | 2020-06-27 |
| 1609402148 | Justine Liao Huang | Physician Assistant | 2725 Pacific Ave, Long Beach, CA 90806-2612 | 2020-03-17 |
| 1962036525 | Gabriel Ernest Smith | Physician Assistant | 4541 Falcon Ave, Long Beach, CA 90807-1814 | 2020-02-22 |
| 1124660295 | Ngawina Veronica Komen | Physician Assistant | 1139 E Ocean Blvd Unit 109, Long Beach, CA 90802-5659 | 2019-10-10 |
| 1326691718 | Chelsea Caughran | Physician Assistant | 472 W Hill St, Long Beach, CA 90806-4548 | 2019-07-24 |
| 1255809216 | Mikaela Terez Zummo | Physician Assistant | 563 E Harrison St, Long Beach, NY 11561-2444 | 2018-11-07 |
| 1407338064 | Monali Patel | Physician Assistant | 237 W Ridgewood, Long Beach, CA 90805-6964 | 2018-08-30 |
| 1437679354 | Alana Doonachar | Physician Assistant | 100 Belmont Avenue, Long Beach, NY 11561 | 2017-06-21 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90804 |
Please comment or provide details below to improve the information on ELDER AUDIO REHAB MEDICAL GROUP INC.
| 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.