Organization
ADVANCED COMMUNITY MEDICAL CARE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL WHITAKER MAXEY MD (MEDICAL DIRECTOR)
(310) 680-1810
Entity
Organization
Contact information
Practice address
701 E 28TH ST STE 100, LONG BEACH, CA 90806-2769
(562) 269-0300
Mailing address
447 N PRAIRIE AVE, INGLEWOOD, CA 90301-1413
(310) 680-1810
(310) 680-1811
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
10/10/2019
Last updated
10/10/2019
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