Organization
CALIFORNIA STATE UNIVERSITY, LONG BEACH
Active
Other names
EMSI
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LACEY WATERS (NETWORK MANAGER)
(214) 689-8144
Entity
Organization
Contact information
Practice address
3640 E 17TH ST, LONG BEACH, CA 90804-2001
(562) 209-2861
Mailing address
3640 E 17TH ST, LONG BEACH, CA 90804-2001
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
436601
CA
305S00000X
Point of Service
Primary
NP9998
CA
Other
Enumeration date
07/25/2012
Last updated
07/25/2012
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