1467818583 NPI number — THE CHILDRENS CLINIC 'SERVING CHILDREN AND THEIR FAMILIES'

Table of content: MRS. LYDIA KRIN SIM RPH (NPI 1255611109)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467818583 NPI number — THE CHILDRENS CLINIC 'SERVING CHILDREN AND THEIR FAMILIES'

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE CHILDRENS CLINIC 'SERVING CHILDREN AND THEIR FAMILIES'
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467818583
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
701 E 28TH ST STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONG BEACH
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90806-2784
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-264-3985
Provider Business Mailing Address Fax Number:
562-216-6197

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 W 12TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90813-2720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-264-3985
Provider Business Practice Location Address Fax Number:
562-216-6197
Provider Enumeration Date:
01/05/2016

Additional Information

Authorized Official

Authorized Official Last Name:
LAWLER
Authorized Official First Name:
JINA
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
CHIEF OPERATIONS OFFICER
Authorized Official Telephone Number:
562-264-3985

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QC1500X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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