Organization
SOUTH BAY SURGICAL AND SPINE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY ROSEKELLY (MANAGER)
(310) 740-4933
Entity
Organization
Contact information
Practice address
4300 LONG BEACH BLVD STE 150, LONG BEACH, CA 90807-2016
(562) 728-0230
(562) 728-0237
Mailing address
4300 LONG BEACH BLVD STE 150, LONG BEACH, CA 90807-2016
(562) 728-0230
(562) 728-0237
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05C0001865
CCN
CA
Enumeration date
05/17/2007
Last updated
01/29/2009
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