Long Beach Memorial Medical
Organization Active NPI Children's Hospital · Long Beach, CA
NPI 1477596583 · NPPES record last updated Apr 8, 2025
Key facts
- NPI
- 1477596583
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Children's Hospital 282NC2000X
- License
- 930000949 (CA)
- Legal business name
- LONG BEACH MEMORIAL MEDICAL
- Practice address
- 2801 Atlantic Ave
Long Beach, CA 90806 - Phone
- (562) 933-5437
- Fax
- (562) 933-8016
- NPI assigned
- Jun 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Chris Finch
- Title
- Chief Compliance Officer
- Phone
- (714) 377-3218
Owners & managing parties with NPI records 4
-
Torin J Cunningham, M.D.
-
Jennifer McNulty, MD
-
Sapna Mehta, DO
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 13
Facilities with the same owner 4
Practitioners 373
-
Stephanie Horwitz Abrams, M.D.
-
Anna Marie Acosta, M.D.
-
Hugh Richard Adams, M.D.
-
John D. Adams Jr., D.O.
-
Felice Cara Adler-Shohet, M.D.
-
Griselda Alvarez, M.D.
-
Fataneh Amidi, MD
-
Rambod Amirnovin, MD
-
Evelina Appleby, MD
-
Jose Luis Aranez, M.D.
-
Vivian T Aranez, M.D.
-
James H Ashizawa, MD
-
Kazuto H Augustus, D.P.M.
-
Juliana Austin, MD
-
Jill Patrice Aversa, RPT
-
Christopher Babbitt, M.D.
-
Marnie Baker, MD
-
Ian Bare, M.D
-
Lauren Ashley Barnes, M.D.
-
Joel D Barron, M.D.
-
Candace Marie Basich, M.D.
-
Fred H Batkin, M.D.
Affiliated clinicians 8
-
Jagmohan S. Batra, M.D.
-
Gary Steven Feldman, M.B.CHB
-
Natalie Michelle Gallant, M.D.
-
Sherry Rose Hytrek, PA-C
-
Zoe Vanessa Kornberg, MD, MPH
-
Hiren Patel, D.O
Medicare Care Compare: Hospital
- Listed as
- Memorial Care Miller Children'S & Women'S Hosp LB
- Type
- Childrens
- Ownership
- Voluntary non-profit - Other
- Medicare certification status
- Active
- Emergency services
- No
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0975370 | Memorialcare Miller Children'S & Women'S | Accreditation | Oct 17, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Hospital certification: CCN 053309
- Legal name
- LONG BEACH MEMORIAL MEDICAL
- Doing business as
- MEMORIALCARE MILLER CHILDREN'S & WOMEN'S HOSPITAL LONG BEACH
- Certification status
- Active
- Provider type (POS)
- Hospital – Children’s
- Participating since
- Jan 12, 2001
- Last certification
- Dec 14, 2018
- Beds
- 354
- Ownership / control type
- Other
- Organization structure
- Corporation · Non-profit
- Incorporated
- Apr 7, 1980 in CA
- Enrollment address
- 2801 Atlantic Ave
Long Beach, CA 90806-1701 - Hospital subgroups
- Acute care, Children’s
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| Sapna a Mehta |
Corporate Director |
Jul 1, 2025 | |
| Eugene Paul Kim |
Corporate Officer |
Feb 1, 2026 | |
| Memorial Health Services |
5% Or Greater Direct Ownership Interest | Apr 7, 1980 | |
| Torin J Cunningham |
Corporate Director |
Jul 1, 2023 | |
| Karyn Gunn |
Corporate Director |
Jul 1, 2024 | |
| Gary Delong |
Corporate Director |
Jul 1, 2023 | |
| Harold Milton Vandyke |
Corporate Director |
Jul 1, 2020 | |
| Andrew Wittenberg |
Corporate Director |
Jul 1, 2021 | |
| Jody S Dial |
Corporate Officer |
Feb 1, 2026 | |
| W-2 Managing Employee |
Feb 1, 2026 | ||
| Katherine Keesal |
Corporate Director |
Jul 1, 2025 | |
| Jennifer a McNulty |
Corporate Director |
Jul 1, 2019 | |
| Mike Munoz |
Corporate Director |
Jul 1, 2025 | |
| Braden Phillips |
Corporate Director |
Jul 1, 2018 | |
| Barry Arbuckle |
Corporate Director | Aug 1, 2002 | |
| Karen Widerynski |
Corporate Director |
Jul 1, 2025 | |
| Darick Simpson |
Corporate Director |
Jul 1, 2023 | |
| Chris Finch |
Corporate Officer |
Dec 1, 2009 | |
| Robert Schack |
Corporate Director |
Jul 1, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090715000720 | CA | Part a Provider - Hospital | 1850311952 | Practice locations: Long Beach, CA; Torrance, CA; Fountain Valley, CA |
National Provider Directory
- Tax ID family
- Miller Children'S Hospital Center
Locations
18785 Brookhurst St
Fountain Valley, CA 92708
Phone (714) 975-1719
19582 Beach Blvd
Ste 370
Huntington Beach, CA 92648
Phone (949) 791-3202
2925 Palo Verde Ave
Long Beach, CA 90815
Phone (562) 421-2757
701 E 28th St
Ste 111
Long Beach, CA 90806
Phone (562) 426-2551
433 E Wardlow Rd
Long Beach, CA 90807
Phone (562) 427-0550
300 Redondo Ave
Long Beach, CA 90814
Phone (562) 433-7496
1760 Termino Ave
Ste 104
Long Beach, CA 90804
Phone (562) 494-8512
2690 Pacific Ave
Ste 380
Long Beach, CA 90806
Phone (562) 595-6426
5300 Katella Ave
Los Alamitos, CA 90720
Phone (562) 430-7533
10861 Cherry St
Los Alamitos, CA 90720
Phone (562) 431-3535
10931 Cherry St
Ste 200
Los Alamitos, CA 90720
Phone (562) 497-9229
3771 Katella Ave
Ste 210
Los Alamitos, CA 90720
Phone (562) 430-0581
6612 Owens Dr
Pleasanton, CA 94588
Phone (928) 460-9191
1650 Pacific Coast Hwy
Ste B
Seal Beach, CA 90740
Phone (562) 230-6089
1309 S Mary Ave
Ste 200
Sunnyvale, CA 94087
Phone (408) 523-3460
23600 Telo Ave
Ste 130
Torrance, CA 90505
Phone (310) 833-1334
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Children's Hospital | 282NC2000X | 930000949 | CA | Yes |
Addresses
Primary practice location
2801 Atlantic Ave
Long Beach, CA 90806
Mailing address
2801 Atlantic Ave
Long Beach, CA 90806-1737
Phone (562) 933-5437
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HSC30727F | Medicaid | CA | |
| HSD30727F | Medicaid | CA | |
| HSP40727F | Medicaid | CA | |
| HSP30727F | Medicaid | CA |
Other names
- Miller Children's Hospital
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Bluemark |
| CONNECT URL | https://52.70.132.174:8191/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other | Medforce Technologies, Inc |
Other providers in Long Beach, CA
- Long Beach Memorial Medical
- Long Beach Memorial Medical
- Long Beach Memorial Medical
- Long Beach Memorial Medical
- Long Beach Memorial Medical
- Long Beach Memorial Medical
- Long Beach Memorial Medical
- Long Beach Memorial Medical
- Long Beach Memorial Medical
- Long Beach Memorial Medical
All providers in Long Beach, CA · Children's Hospital in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.