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Organization
LONG BEACH ANESTHESIA MEDICAL GROUP
Active
Organization
LONG BEACH ANESTHESIA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURA ANNE RUSSELL M.D. (PRESIDENT)
(714) 347-1000
Entity
Organization
Contact information
Practice address
1050 LINDEN AVE, LONG BEACH, CA 90813
(562) 491-9000
Mailing address
210 N TUSTIN AVE, SANTA ANA, CA 92705-3807
(714) 347-1000
(714) 647-1245
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
FNP16965
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0046640
—
CA
Enumeration date
07/13/2006
Last updated
08/16/2018
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