Organization Active NPI

Leslie H Edrich, M.D., Inc

  • Specialist
  • Long Beach, CA
National Provider Identifier
1508997966
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G48000 Issued in CA
Legal business name
LESLIE H EDRICH, M.D., INC
Practice address
701 E 28TH St
Suite 400
Long Beach, CA 90806-2759
Phone
(562) 427-9929
Fax
(562) 427-2565
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Authorized official

Name
Dr. Leslie Howard Edrich, M.D.
Title
Owner
Phone
(562) 427-9929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X G48000 CA Primary

Addresses

Primary practice location

701 E 28TH St
Suite 400
Long Beach, CA 90806-2759

Mailing address

701 E 28TH St
Suite 400
Long Beach, CA 90806-2759
Phone (562) 427-9929

Other identifiers 1

IdentifierTypeStateIssuer
00G480000MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1508997966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E 28TH ST",
            "address_2": "SUITE 400",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062759",
            "telephone_number": "562-427-9929",
            "fax_number": "562-427-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E 28TH ST",
            "address_2": "SUITE 400",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062759",
            "telephone_number": "562-427-9929",
            "fax_number": "562-427-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESLIE H EDRICH, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "EDRICH",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-427-9929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G48000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G480000",
            "state": "CA"
        }
    ],
    "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 28, 2008; 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.