| Long Beach Memorial Medical | |
|
2801 Atlantic Ave Long Beach CA 90806-1701 | |
| (562) 933-2000 | |
| Not Available |
| Full Name | Long Beach Memorial Medical |
|---|---|
| Speciality | Clinic/Center |
| Location | 2801 Atlantic Ave, Long Beach, California |
| Authorized Official Name and Position | Chris Finch (CHIEF COMPLIANCE OFFICER) |
| Authorized Official Contact | 7143773218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Long Beach Memorial Medical 2801 Atlantic Ave Long Beach CA 90806-1701 Ph: () - | Long Beach Memorial Medical 2801 Atlantic Ave Long Beach CA 90806-1701 Ph: (562) 933-2000 |
| NPI Number | 1477036382 |
|---|---|
| Provider Enumeration Date | 09/07/2018 |
| Last Update Date | 09/07/2018 |
| Medicare PECOS PAC ID | 1850311952 |
|---|---|
| Medicare Enrollment ID | O20190402001092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477036382 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Mary Byrne Welch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417944372 PECOS PAC ID: 1759276330 Enrollment ID: I20040220001131 |
| Provider Name | Stacy Lee Parker Byone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124202361 PECOS PAC ID: 6901941681 Enrollment ID: I20100305000258 |
| Provider Name | Deneen M Boyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902262744 PECOS PAC ID: 2062785504 Enrollment ID: I20170906000994 |
| Provider Name | Dea Kurtovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528498771 PECOS PAC ID: 8224347067 Enrollment ID: I20190509002870 |
| Provider Name | Jamie Marie Balderas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861973034 PECOS PAC ID: 7810327970 Enrollment ID: I20211213001439 |
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