Beach Physical Medicine Pc | |
5512 E Britton Dr Ste 100 Long Beach CA 90815-3149 | |
(562) 594-6644 | |
Not Available |
Full Name | Beach Physical Medicine Pc |
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Speciality | General Practice |
Location | 5512 E Britton Dr Ste 100, Long Beach, California |
Authorized Official Name and Position | Nathanial Lynott (AUTHORIZED OFFICIAL) |
Authorized Official Contact | 5625946644 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Beach Physical Medicine Pc 5512 E Britton Dr Ste 100 Long Beach CA 90815-3149 Ph: (562) 594-6644 | Beach Physical Medicine Pc 5512 E Britton Dr Ste 100 Long Beach CA 90815-3149 Ph: (562) 594-6644 |
NPI Number | 1356053508 |
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Provider Enumeration Date | 12/20/2022 |
Last Update Date | 03/27/2023 |
Medicare PECOS PAC ID | 2466825120 |
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Medicare Enrollment ID | O20230227002992 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356053508 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Nathanial F Lynott |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1154594570 PECOS PAC ID: 0648209668 Enrollment ID: I20050810000724 |
Provider Name | Nahom Tassew |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316689185 PECOS PAC ID: 3678953460 Enrollment ID: I20220711002904 |
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