Organization Active NPI

Alan W. Heller, M.D., a Professional Medical Corporation

  • Dermatology Physician
  • Long Beach, CA
National Provider Identifier
1083124598
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ALAN W. HELLER, M.D., A PROFESSIONAL MEDICAL CORPORATION
Practice address
1760 Termino Ave Ste 114
Long Beach, CA 90804-2169
Phone
(562) 498-2459
NPI assigned
Oct 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Teri Kruidhof
Title
Nurse
Phone
(562) 498-2459

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X
Pediatric Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NP0225X
Procedural Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NS0135X
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X
Surgery of the Hand (Plastic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2082S0105X

Addresses

Primary practice location

1760 Termino Ave Ste 114
Long Beach, CA 90804-2169

Mailing address

1760 Termino Ave Ste 114
Long Beach, CA 90804-2169
Phone (562) 498-2459

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507593600000",
    "number": "1083124598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 TERMINO AVE STE 114",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042169",
            "telephone_number": "562-498-2459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 TERMINO AVE STE 114",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042169",
            "telephone_number": "562-498-2459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAN W. HELLER, M.D., A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A",
        "authorized_official_last_name": "KRUIDHOF",
        "authorized_official_first_name": "TERI",
        "authorized_official_title_or_position": "NURSE",
        "authorized_official_telephone_number": "562-498-2459"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.