Organization
THE CHILDRENS CLINIC 'SERVING CHILDREN AND THEIR FAMILIES'
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISA NICHOLAS MD (CHIEF EXECUTIVE OFFICER)
(562) 264-3551
Entity
Organization
Contact information
Practice address
1500 E ANAHEIM ST STE 100, LONG BEACH, CA 90813-4051
(562) 277-9400
(562) 216-6198
Mailing address
701 E 28TH ST STE 200, LONG BEACH, CA 90806-2784
(562) 264-3114
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
02/14/2019
Last updated
04/16/2024
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