| Pacific Burnett Medical Clinic | |
|
2491 Pacific Ave Suite 3 Long Beach CA 90806-2900 | |
| (213) 444-6271 | |
| (909) 992-3302 |
| Full Name | Pacific Burnett Medical Clinic |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2491 Pacific Ave, Long Beach, California |
| Authorized Official Name and Position | Lawrence O Ogbechie (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2134446271 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Burnett Medical Clinic 1142 S Diamond Bar Blvd Suite 406 Diamond Bar CA 91765-2203 Ph: (213) 444-6271 | Pacific Burnett Medical Clinic 2491 Pacific Ave Suite 3 Long Beach CA 90806-2900 Ph: (213) 444-6271 |
| NPI Number | 1588611461 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 02/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588611461 | NPI | - | NPPES |
| GR0082750 | Medicaid | CA | |
| 00A619590 | Other | CA | LA MENTAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A61959 (California) | Primary |
| 208D00000X | General Practice | A61959 (California) | Secondary |
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