Provider Demographics
NPI:1285848374
Name:CITY OF LONG BEACH
Entity type:Organization
Organization Name:CITY OF LONG BEACH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEEALH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANISSA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-570-4047
Mailing Address - Street 1:2525 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1765
Mailing Address - Country:US
Mailing Address - Phone:562-570-4331
Mailing Address - Fax:562-570-1266
Practice Address - Street 1:2525 GRAND AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1765
Practice Address - Country:US
Practice Address - Phone:562-570-4331
Practice Address - Fax:562-570-1266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management