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2525 Grand Ave Room #260 Long Beach CA 90815-1765 | |
(562) 570-4075 | |
(562) 570-4070 |
Full Name | |
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Speciality | Clinical Medical Laboratory |
Location | 2525 Grand Ave, Long Beach, California |
Authorized Official Name and Position | Anissa Danielle Davis (HEALTH OFFICER) |
Authorized Official Contact | 5625704047 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2525 Grand Ave Room #260 Long Beach CA 90815-1765 Ph: (562) 570-4075 | 2525 Grand Ave Room #260 Long Beach CA 90815-1765 Ph: (562) 570-4075 |
NPI Number | 1083638530 |
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Provider Enumeration Date | 07/27/2006 |
Last Update Date | 11/13/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083638530 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP0905X | Clinic/center - Public Health, State Or Local | (* (Not Available)) | Secondary |
291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Primary |
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