Organization
CALIFORNIA STATE UNIVERSITY LONG BEACH
Active
Parent organization
CALIFORNIA STATE UNIVERSITY LONG BEACH
Other names
PT@TheBeach
Organization subpart
Yes
Provider details
NPI number
Legal business name
CALIFORNIA STATE UNIVERSITY LONG BEACH
Authorized official
JAMES BUENAVENTURA (DIRECTOR)
(562) 985-8286
Entity
Organization
Contact information
Practice address
1250 N BELLFLOWER BLVD, KIN-105, LONG BEACH, CA 90840-0004
(562) 985-8286
Mailing address
1250 N BELLFLOWER BLVD, KIN-105, LONG BEACH, CA 90840-0004
(562) 985-8286
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/05/2013
Last updated
04/09/2015
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