Provider Demographics
NPI:1306296835
Name:MY PEDIATRICS AND RESPIRATORY CARE CLINIC
Entity type:Organization
Organization Name:MY PEDIATRICS AND RESPIRATORY CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LEILA
Authorized Official - Middle Name:MARIAM
Authorized Official - Last Name:YOONESSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:562-489-7405
Mailing Address - Street 1:720 ALAMITOS AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-4726
Mailing Address - Country:US
Mailing Address - Phone:562-489-7405
Mailing Address - Fax:
Practice Address - Street 1:720 ALAMITOS AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-4726
Practice Address - Country:US
Practice Address - Phone:562-489-7405
Practice Address - Fax:562-489-7406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2080P0214X
CAA114034208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric PulmonologyGroup - Multi-Specialty