California State University, Long Beach

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

NP9998 Issued in CA

Legal business name

CALIFORNIA STATE UNIVERSITY, LONG BEACH

Practice address

3640 E 17TH St
Long Beach, CA 90804-2001

Phone

(562) 209-2861

NPI assigned

Jul 25, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Lacey Waters

Title

Network Manager

Phone

(214) 689-8144

Specialties & licenses 2

Addresses

Other names 1

• EMSI Other name

Practitioners 1

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

• Anthony William McGuire, RN, PHD, ACNP-BC

  • Acute Care Nurse Practitioner
  • Long Beach, CA
  • NPI 1003162025
  NPD (past)

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

{
    "created_epoch": "1343174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343174400000",
    "number": "1780930990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 E 17TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 E 17TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042001",
            "telephone_number": "562-209-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA STATE UNIVERSITY, LONG BEACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-25",
        "last_updated": "2012-07-25",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "LACEY",
        "authorized_official_title_or_position": "NETWORK MANAGER",
        "authorized_official_telephone_number": "214-689-8144",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "436601",
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "NP9998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EMSI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• California Juco Hoops Report
• California Radiation Oncology Medical Group, Inc.
• California Rehabilitation & Sports Therapy a California Physical Ther
• California State University at Long Beach
• California State University Long Beach
• California Surgical Suites, LLC
• Donna Marie Camagay Calima, DMD
• Dante Calimon
• Madeline Calixte
• Gilross Calixto

• Point of Service in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Point of Service in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; 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.