St. Mary Medical Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ST. MARY MEDICAL CENTER

Practice address

1045 Atlantic Ave
Suite 914
Long Beach, CA 90813-3408

Phone

(562) 624-4977

NPI assigned

Nov 10, 2015

Organization subpart

No

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

Authorized official

Name

Marica Alcouloumre, MD

Title

Medical Director

Phone

(562) 624-4900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447113600000",
    "number": "1285007419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 ATLANTIC AVE",
            "address_2": "SUITE 914",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133408",
            "telephone_number": "562-624-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 ATLANTIC AVE",
            "address_2": "SUITE 914",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133408",
            "telephone_number": "562-624-4977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2015-11-10",
        "status": "A",
        "authorized_official_last_name": "ALCOULOUMRE",
        "authorized_official_first_name": "MARICA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "562-624-4900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Henry St. Jean
• Tina St. Julian
• Lia S St. Junius
• St. Mary Health Ventures Inc (Atlantic Professional Pharmacy)
• St. Mary Health Ventures, Inc. (Medical Mall Pharmacy)
• St. Marys Radiation Oncology Medical Group
• St. Michael Surgery Center, LLC
• Sarah St.John
• Kei'Sharra Stacy
• Colleen Stafford

• Clinic/Center in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.