ATLANTIC UROLOGY MEDICAL GROUP INC NPI 1467649764

NPI Information

  • NPI: 1467649764
  • Provider Name: ATLANTIC UROLOGY MEDICAL GROUP INC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 05D0554349
  • Address: 701 E 28TH ST
    SUITE 319
    LONG BEACH, CA
    ZIP 90806
  • Phone: (562) 595-5977

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NPI Details

ATLANTIC UROLOGY MEDICAL GROUP INC is a specialist in Long Beach, CA. The provider is 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. ATLANTIC UROLOGY MEDICAL GROUP INC NPI is 1467649764. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

701 E 28TH ST
SUITE 319
LONG BEACH, CA
ZIP 90806-759
Phone: (562) 595-5977
Fax: (562) 490-0509

The provider's authorized official is Wendy Solis .
The authorized official title is Office Manager and has the following contact phone number (562) 595-5977.

The CLIA number assigned to this NPI record is 05D0554349 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/1/2007 and was last updated on 8/27/2019.

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
1174400000XSpecialistA32052CALIFORNIAYes

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
1W9927OTHERCALIFORNIAMEDICARE ID
22405716MEDICAIDCALIFORNIA

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: 3/30/2025

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