NPIMap

Organization Active NPI

Long Beach Memorial Medical

Doing business as Miller Children's Hospital

  • Children's Hospital
  • Long Beach, CA
National Provider Identifier
1477596583
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
License
930000949 Issued in CA
Legal business name
LONG BEACH MEMORIAL MEDICAL
Doing business as
Miller Children's Hospital
Practice address
2801 Atlantic Ave
Long Beach, CA 90806
Phone
(562) 933-5437
Fax
(562) 933-8016
NPI assigned
Jun 14, 2006
Last updated
Apr 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Authorized official

Name
Chris Finch
Title
Chief Compliance Officer
Phone
(714) 377-3218

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Hospital 282NC2000X 930000949 CA Primary

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 4

IdentifierTypeStateIssuer
HSD30727FMedicaidCA
HSC30727FMedicaidCA
HSP30727FMedicaidCA
HSP40727FMedicaidCA

Other names 1

  • Miller Children's Hospital Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090715000720 CA Part A Provider - Hospital 1850311952 Practice locations: Long Beach, CA; Torrance, CA; Fountain Valley, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477596583. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Apr 7, 1980 in CA
Enrollment address
2801 Atlantic Ave
Long Beach, CA 90806-1701
Main/Primary Hospital Location
Hospital subgroups
Acute care, Children’s

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Memorial Care Miller Children's & Women's Hosp LBCCN 053309 · All quality measures
Type
Childrens
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0975370Memorialcare Miller Children's & Women's2801 Atlantic Ave, Long Beach, CA 90806AccreditationOct 17, 2026

National Provider Directory

National Provider Directory
Tax ID family
Long Beach Medical Center14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

1901 Newport Blvd
Ste 235
Costa Mesa, CA 92627
Phone (562) 490-3580

11480 Brookshire Ave
Ste 308
Downey, CA 90241
Phone (562) 862-3656

2110 E El Segundo Blvd
Ste 210
El Segundo, CA 90245
Phone (310) 784-8704

1400 N Harbor Blvd
Ste 101
Fullerton, CA 92835
Phone (714) 888-2080

13830 Brookhurst St
Garden Grove, CA 92843
Phone (714) 467-4330

19582 Beach Blvd
Ste 370
Huntington Beach, CA 92648
Phone (949) 791-3202

25431 Cabot Rd
Ste 118
Laguna Hills, CA 92653
Phone (949) 362-8877

1040 Elm Ave
Ste 302
Long Beach, CA 90813
Phone (562) 495-4952

1045 Atlantic Ave
Ste 808
Long Beach, CA 90813
Phone (562) 473-4471

1703 Termino Ave
Ste 206
Long Beach, CA 90804
Phone (562) 257-8147

2690 Pacific Ave
Ste 380
Long Beach, CA 90806
Phone (562) 595-6426

2760 Atlantic Ave
Long Beach, CA 90806
Phone (542) 424-6666

2865 Atlantic Ave
Ste 104
Long Beach, CA 90806
Phone (562) 933-1820

3325 Palo Verde Ave
Long Beach, CA 90808
Phone (310) 982-0010

3530 Atlantic Ave
Ste 108
Long Beach, CA 90807
Phone (310) 613-4065

3760 Atlantic Ave
Long Beach, CA 90807
Phone (562) 595-7467

3828 Schaufele Ave
Long Beach, CA 90808
Phone (657) 241-8990

5977 E Spring St
Long Beach, CA 90808
Phone (562) 421-3727

10861 Cherry St
Los Alamitos, CA 90720
Phone (562) 430-3998

23512 Madero
Mission Viejo, CA 92691
Phone (949) 583-1600

1650 Pacific Coast Hwy
Ste B
Seal Beach, CA 90740
Phone (562) 230-6089

2780 Skypark Dr
Ste 350
Torrance, CA 90505
Phone (310) 986-6511

400 N Mountain Ave
Ste 310
Upland, CA 91786
Phone (909) 920-0876

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sapna a Mehta Individual Corporate DirectorBoard Member Jul 1, 2025
Eugene Paul Kim Individual Corporate OfficerChief Executive Officer Feb 1, 2026
Memorial Health Services Organization, Fountain Valley, CA Corporation 5% Or Greater Direct Ownership Interest Apr 7, 1980
Torin J Cunningham Individual Corporate DirectorBoard Member Jul 1, 2023
Karyn Gunn Individual Corporate DirectorBoard Member Jul 1, 2024
Gary Delong Individual Corporate DirectorBoard Member Jul 1, 2023
Harold Milton Vandyke Individual Corporate DirectorBoard Member Jul 1, 2020
Andrew Wittenberg Individual Corporate DirectorBoard Member Jul 1, 2021
Jody S Dial Individual Corporate OfficerChief Financial Officer Feb 1, 2026
W-2 Managing EmployeeChief Financial Officer Feb 1, 2026
Katherine Keesal Individual Corporate DirectorBoard Member Jul 1, 2025
Jennifer a McNulty Individual Corporate DirectorBoard Member Jul 1, 2019
Mike Munoz Individual Corporate DirectorBoard Member Jul 1, 2025
Braden Phillips Individual Corporate DirectorBoard Member Jul 1, 2018
Barry Arbuckle Individual Corporate Director Aug 1, 2002
Karen Widerynski Individual Corporate DirectorBoard Member Jul 1, 2025
Darick Simpson Individual Corporate DirectorBoard Member Jul 1, 2023
Chris Finch Individual Corporate OfficerChief Compliance Officer Dec 1, 2009
Robert Schack Individual Corporate DirectorBoard Member Jul 1, 2018

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 373

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 373

Affiliated clinicians 8

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744070400000",
    "number": "1477596583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061737",
            "telephone_number": "562-933-5437",
            "fax_number": "562-933-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90806",
            "telephone_number": "562-933-5437",
            "fax_number": "562-933-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG BEACH MEMORIAL MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A",
        "authorized_official_last_name": "FINCH",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "714-377-3218"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "CA",
            "license": "930000949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSD30727F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSC30727F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP30727F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP40727F",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "Bluemark",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd Ste 120",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611039",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://52.70.132.174:8191/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2003.1",
            "affiliationName": "Medforce Technologies, Inc",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2348 SW Topeka Blvd",
            "city": "Topeka",
            "state": "KS",
            "country_code": "US",
            "postal_code": "666111283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Miller Children's Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Miller Children's Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.