| Priority Care Medical Group-long Beach 1 | |
|
455 W Willow St Long Beach CA 90806-2843 | |
| (562) 427-1700 | |
| (562) 427-2116 |
| Full Name | Priority Care Medical Group-long Beach 1 |
|---|---|
| Speciality | Clinic/Center |
| Location | 455 W Willow St, Long Beach, California |
| Authorized Official Name and Position | Marisol Ramirez (CAO) |
| Authorized Official Contact | 8188995555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Priority Care Medical Group-long Beach 1 6609 Van Nuys Blvd Ste 201-a Van Nuys CA 91405-4618 Ph: (818) 812-5410 | Priority Care Medical Group-long Beach 1 455 W Willow St Long Beach CA 90806-2843 Ph: (562) 427-1700 |
| NPI Number | 1154803674 |
|---|---|
| Provider Enumeration Date | 08/31/2018 |
| Last Update Date | 06/13/2024 |
| Certification Date | 06/13/2024 |
| Medicare PECOS PAC ID | 3678714201 |
|---|---|
| Medicare Enrollment ID | O20250810000117 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154803674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (NU) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (NU) | Primary |
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