# WEST COAST ENDOCRINE A PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1932300944
- **Authorized official:** JENNIFER CONNELLY DO (OWNER)
- **Authorized official phone:** (562) 988-0040

## Contact information

- **Practice address:** 5500 E ATHERTON ST, SUITE 416, LONG BEACH, CA 90815-4016
- **Practice address phone:** (562) 988-0040
- **Practice address fax:** (562) 988-0041
- **Mailing address:** 5500 E ATHERTON ST, SUITE 416, LONG BEACH, CA 90815-4016
- **Mailing address phone:** (562) 988-0040
- **Mailing address fax:** (562) 988-0041

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133N00000X | Nutritionist | W17025 | CA | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | W17025 | CA | Yes |

## Other

- **Enumeration date:** 05/29/2007
- **Last updated:** 01/22/2018