Organization
LONG BEACH PET IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY A. DOBKIN MD (MEDICAL DIRECTOR)
(562) 427-0714
Entity
Organization
Contact information
Practice address
2708 E WILLOW ST, SIGNAL HILL, CA 90755-2217
(562) 427-3652
(562) 427-3652
Mailing address
2708 E WILLOW ST, SIGNAL HILL, CA 90755-2217
(562) 427-3652
(562) 427-3652
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
6936-19
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470001534
RAILROAD MEDICARE
CA
05
—
EXE70146F
—
CA
01
—
ZZZ01950Z
BLUE SHIELD
CA
Enumeration date
06/11/2006
Last updated
06/06/2013
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