| Adult & Child Neurology Medical Associates Inc. | |
|
2880 Atlantic Ave 260 Long Beach CA 90806-1714 | |
| (562) 490-3580 | |
| (562) 490-3584 |
| Full Name | Adult & Child Neurology Medical Associates Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2880 Atlantic Ave, Long Beach, California |
| Authorized Official Name and Position | Thanh T Le (TREASURER) |
| Authorized Official Contact | 5624903580 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adult & Child Neurology Medical Associates Inc. 2880 Atlantic Ave 260 Long Beach CA 90806-1714 Ph: (562) 490-3580 | Adult & Child Neurology Medical Associates Inc. 2880 Atlantic Ave 260 Long Beach CA 90806-1714 Ph: (562) 490-3580 |
| NPI Number | 1013959402 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 06/10/2015 |
| Medicare PECOS PAC ID | 1355437914 |
|---|---|
| Medicare Enrollment ID | O20071012000629 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013959402 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | G77927 (California) | Primary |
| Provider Name | Thanh T Le |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134165350 PECOS PAC ID: 6709972268 Enrollment ID: I20080616000412 |
| Provider Name | Mary K Dyes |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891737219 PECOS PAC ID: 3072609536 Enrollment ID: I20111215000470 |
| Provider Name | Jean L Lake |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386686673 PECOS PAC ID: 2264528728 Enrollment ID: I20111228000248 |
| Provider Name | Nicole H Cobo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497954119 PECOS PAC ID: 1254566771 Enrollment ID: I20131108000381 |
| Provider Name | Jasmin Dao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164811568 PECOS PAC ID: 8022397447 Enrollment ID: I20200303002789 |
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