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Organization
ROOTS ADDICTION AND PSYCHIATRY MEDICAL GROUP, PC
Active
Organization
ROOTS ADDICTION AND PSYCHIATRY MEDICAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREI DOKUKIN MD (CEO)
(562) 304-9592
Entity
Organization
Contact information
Practice address
3939 ATLANTIC AVE STE 100, LONG BEACH, CA 90807-3529
(562) 473-0825
(562) 473-0825
Mailing address
3939 ATLANTIC AVE STE 100, LONG BEACH, CA 90807-3529
(562) 473-0825
(562) 473-0825
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
05/26/2023
Last updated
10/30/2024
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