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Organization
LONG BEACH PET IMAGING CENTER LLC
Active
Organization
LONG BEACH PET IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY A. DOBKIN MD (MEDICAL DIRECTOR)
(562) 427-0714
Entity
Organization
Contact information
Practice address
2708 E WILLOW ST, SIGNAL HILL, CA 90755-2217
(562) 427-3652
(562) 427-3652
Mailing address
2708 E WILLOW ST, SIGNAL HILL, CA 90755-2217
(562) 427-3652
(562) 427-3652
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
6936-19
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470001534
RAILROAD MEDICARE
CA
05
—
EXE70146F
—
CA
01
—
ZZZ01950Z
BLUE SHIELD
CA
Enumeration date
06/11/2006
Last updated
06/06/2013
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