Organization
GREATER LONG BEACH VASCULAR ACCESS, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIA KHWAJA MD (VICE PRESIDENT)
(562) 867-5300
Entity
Organization
Contact information
Practice address
16506 LAKEWOOD BLVD, SUITE 200, BELLFLOWER, CA 90706-5164
(562) 867-5300
(562) 867-8666
Mailing address
16506 LAKEWOOD BLVD, SUITE 200, BELLFLOWER, CA 90706-5164
(562) 867-5300
(562) 867-8666
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447587126
—
CA
Enumeration date
11/17/2009
Last updated
09/20/2011
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