ST NAZARENE MEDICAL CLINIC INC NPI 1093966822

NPI Information

NPI: 1093966822
Provider Name: ST NAZARENE MEDICAL CLINIC INC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
2403 ATLANTIC AVE
LONG BEACH, CA
ZIP 90806
Phone: (562) 989-0145
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ST NAZARENE MEDICAL CLINIC INC is a primary care clinic center in Long Beach, CA. ST NAZARENE MEDICAL CLINIC INC NPI is 1093966822. The provider is registered as an organization entity type.

The provider's business location address is:

2403 ATLANTIC AVE
LONG BEACH, CA
ZIP 90806-221
Phone: (562) 989-0145
Fax: (562) 989-2135

The provider's authorized official is Suzanne L Fussell .
The authorized official title is President and has the following contact phone number (562) 989-0145.

The enumeration date for this NPI number is 10/10/2008 and was last updated on 10/10/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	A055383	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W14367	MEDICARE UPIN	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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