Connexus Family Clinic Inc

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

CONNEXUS FAMILY CLINIC INC

Practice address

1930 E. Anaheim Street
N/a
Long Beach, CA 90813-3908

Phone

(562) 599-2248

Fax

(562) 599-8801

NPI assigned

Dec 19, 2018

Organization subpart

No

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

Authorized official

Name

Samantha Gooding, FNP

Title

Cfo

Phone

(323) 506-9860

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1477025278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 E. ANAHEIM STREET",
            "address_2": "N/A",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133908",
            "telephone_number": "562-599-2248",
            "fax_number": "562-599-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 E. ANAHEIM STREET",
            "address_2": "N/A",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133908",
            "telephone_number": "562-599-2248",
            "fax_number": "562-599-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNEXUS FAMILY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-19",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "GOODING",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "323-506-9860",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "A44667",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Medicine Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Adult Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.