# LONG BEACH PRIME MEDICAL GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205955986
- **Authorized official:** G.B. HAERI MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (562) 997-7100

## Contact information

- **Practice address:** 4014 LONG BEACH BLVD, \#210, LONG BEACH, CA 90807-5407
- **Practice address phone:** (562) 997-7100
- **Practice address fax:** (562) 981-9423
- **Mailing address:** 4014 LONG BEACH BLVD, \#210, LONG BEACH, CA 90807-5407
- **Mailing address phone:** (562) 997-7100
- **Mailing address fax:** (562) 981-9423

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | CA | Yes |

## Other

- **Enumeration date:** 03/27/2007
- **Last updated:** 07/21/2022