Organization
LONG BEACH COMMUNITY CLINICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MINTRA SHARMA WILSON MA (ADMINISTRATOR)
(310) 767-6620
Entity
Organization
Contact information
Practice address
2272 PACIFIC AVE, LONG BEACH, CA 90806-4312
(562) 438-3087
Mailing address
PO BOX 2244, PALOS VERDES ESTATES, CA 90274-8244
(310) 767-6620
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
05/03/2023
Last updated
05/03/2023
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