Organization
CONNEXUS FAMILY CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA GOODING FNP (CFO)
(323) 506-9860
Entity
Organization
Contact information
Practice address
1930 E. ANAHEIM STREET, N/A, LONG BEACH, CA 90813-3908
(562) 599-2248
(562) 599-8801
Mailing address
1930 E. ANAHEIM STREET, N/A, LONG BEACH, CA 90813-3908
(562) 599-2248
(562) 599-8801
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A44667
PHYSICIAN LICENSE
CA
Enumeration date
12/19/2018
Last updated
04/12/2021
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