NPIMap

Organization Active NPI

Long Beach Prime Medical Group Inc

  • Orthopaedic Surgery Physician
  • Long Beach, CA
National Provider Identifier
1205955986
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
LONG BEACH PRIME MEDICAL GROUP INC
Practice address
4014 Long Beach Blvd
#210
Long Beach, CA 90807-5407
Phone
(562) 997-7100
Fax
(562) 981-9423
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
G.B. Haeri, MD
Title
Medical Director
Phone
(562) 997-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X CA Primary

Addresses

Primary practice location

4014 Long Beach Blvd
#210
Long Beach, CA 90807-5407

Mailing address

4014 Long Beach Blvd
#210
Long Beach, CA 90807-5407
Phone (562) 997-7100

National Provider Directory

National Provider Directory

Locations

4014 Long Beach Blvd
Ste 210
Long Beach, CA 90807
Phone (562) 997-7100

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1205955986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 LONG BEACH BLVD",
            "address_2": "#210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908075407",
            "telephone_number": "562-997-7100",
            "fax_number": "562-981-9423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 LONG BEACH BLVD",
            "address_2": "#210",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908075407",
            "telephone_number": "562-997-7100",
            "fax_number": "562-981-9423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG BEACH PRIME MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HAERI",
        "authorized_official_first_name": "G.B.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "562-997-7100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "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 Jul 21, 2022; 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.