# LONG BEACH MEDISPA MANAGEMENT, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LONG BEACH MEDISPA MANAGEMENT, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1932583085
- **Legal business name:** LONG BEACH MEDISPA MANAGEMENT, INC.
- **Authorized official:** DAVID S SILVER M.D. (PHYSICIAN)
- **Authorized official phone:** (562) 612-0950

## Contact information

- **Practice address:** 2370 LONG BEACH BLVD, LONG BEACH, CA 90806-3260
- **Practice address phone:** (562) 612-0950
- **Mailing address:** 2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
- **Mailing address phone:** (310) 943-4180
- **Mailing address fax:** (888) 431-8819

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | G73514 | CA | Yes |

## Other

- **Enumeration date:** 07/17/2015
- **Last updated:** 08/25/2015