1891912788 NPI number — COUNTY OF LOS ANGELES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891912788 NPI number — COUNTY OF LOS ANGELES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF LOS ANGELES
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:
LONG BEACH COMP HEALTH CTR PHY
Provider Other Organization Name Type Code:
3
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:
1891912788
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1333 CHESTNUT AVE
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:
90813-2944
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-599-8723
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1333 CHESTNUT AVE
Provider Second Line Business Practice Location Address:
PHARMACY DEPARTMENT
Provider Business Practice Location Address City Name:
LONG BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90813-2944
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-599-8723
Provider Business Practice Location Address Fax Number:
562-591-3348
Provider Enumeration Date:
04/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CHEN
Authorized Official First Name:
PETER
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACY OFFICER
Authorized Official Telephone Number:
562-599-8723

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  PHE32435 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2076786 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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