Active NPI
Ernest Prochazka
- Occupational Medicine Physician
- Long Beach, CA
National Provider Identifier
1881872489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- C51296
- Practice address
- 6147 E Huntdale St
Long Beach, CA 90808-2937 - Phone
- (361) 537-3576
- NPI assigned
- Feb 6, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | C51296 | CA | Primary |
Addresses
Primary practice location
6147 E Huntdale St
Long Beach, CA 90808-2937
Mailing address
6147 E Huntdale St
Long Beach, CA 90808-2937
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51296 | CA | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sand Canyon Medical Group | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Urgent Care Clinic/Center
- Irvine, CA
- NPI 1962688390
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202256000000",
"number": "1881872489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6147 E HUNTDALE ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908082937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6147 E HUNTDALE ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908082937",
"telephone_number": "361-537-3576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROCHAZKA",
"first_name": "ERNEST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-06",
"last_updated": "2008-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "CA",
"license": "C51296",
"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 Feb 6, 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.