Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
GREEN, STUART & MARINOW, HARRY & BONFILIO, NICHOLAS & FEIWELL, LAWRENC
Active
Organization
GREEN, STUART & MARINOW, HARRY & BONFILIO, NICHOLAS & FEIWELL, LAWRENC
Active
Other names
GREATER LONG BEACH ORTHOPAEDIC SURGICAL & MEDICAL GROUP A PTRSHP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUKE AHN M.D. (MANAGING PARTNER)
(562) 430-3561
Entity
Organization
Contact information
Practice address
3771 KATELLA AVE, SUITE 310, LOS ALAMITOS, CA 90720-3115
(562) 430-3561
(562) 431-8882
Mailing address
1040 ELM AVE, SUITE 100, LONG BEACH, CA 90813-3265
(562) 591-4444
(562) 436-7350
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0066741
—
CA
01
—
W13148A
OTHER PTAN
—
01
—
W13148B
PTAN
—
01
—
ZZZ53512Z
BLUE SHIELD PIN NUMBER
CA
Enumeration date
07/31/2007
Last updated
02/01/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers