NPIMap

Organization Active NPI

South Bay Psychiatric Group, a Medical Corporation

  • Psychiatry Physician
  • Long Beach, CA
National Provider Identifier
1770142440
Registry record updated Jun 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SOUTH BAY PSYCHIATRIC GROUP, A MEDICAL CORPORATION
Practice address
2776 Pacific Ave
Long Beach, CA 90806-2613
Phone
(562) 997-2000
NPI assigned
Jun 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2019

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

Authorized official

Name
Mr. Hiruy Gessesse, MDNPI 1902091481
Title
President
Phone
(424) 400-7748

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

2776 Pacific Ave
Long Beach, CA 90806-2613

Mailing address

PO Box 4570
Palos Verdes Peninsula, CA 90274-9607
Phone (424) 400-7748

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559779200000",
    "number": "1770142440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4570",
            "city": "PALOS VERDES PENINSULA",
            "state": "CA",
            "postal_code": "902749607",
            "telephone_number": "424-400-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2776 PACIFIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062613",
            "telephone_number": "562-997-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY PSYCHIATRIC GROUP, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-06",
        "status": "A",
        "authorized_official_last_name": "GESSESSE",
        "authorized_official_first_name": "HIRUY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "424-400-7748",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 6, 2019; 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.