| Beach Physical Medicine PC | |
|
5512 E Britton Dr Ste 100 Long Beach CA 90815-3149 | |
| (562) 594-6644 | |
| Not Available |
| Full Name | Beach Physical Medicine PC |
|---|---|
| Speciality | General Practice |
| Location | 5512 E Britton Dr Ste 100, Long Beach, California |
| Authorized Official Name and Position | Nathanial Lynott (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5625946644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beach Physical Medicine PC 5512 E Britton Dr Ste 100 Long Beach CA 90815-3149 Ph: (562) 594-6644 | Beach Physical Medicine PC 5512 E Britton Dr Ste 100 Long Beach CA 90815-3149 Ph: (562) 594-6644 |
| NPI Number | 1356053508 |
|---|---|
| Provider Enumeration Date | 12/20/2022 |
| Last Update Date | 03/27/2023 |
| Certification Date | 03/27/2023 |
| Medicare PECOS PAC ID | 2466825120 |
|---|---|
| Medicare Enrollment ID | O20230227002992 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356053508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (NU) | Primary |
| Provider Name | Nathanial F Lynott |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1154594570 PECOS PAC ID: 0648209668 Enrollment ID: I20050810000724 |
| Provider Name | Nahom Tassew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316689185 PECOS PAC ID: 3678953460 Enrollment ID: I20220711002904 |
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