West Coast Endocrine a Professional Corporation

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

W17025 Issued in CA

Legal business name

WEST COAST ENDOCRINE A PROFESSIONAL CORPORATION

Practice address

5500 E Atherton St
Suite 416
Long Beach, CA 90815-4016

Phone

(562) 988-0040

Fax

(562) 988-0041

NPI assigned

May 29, 2007

Organization subpart

No

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

Authorized official

Name

Jennifer Connelly, DO

Title

Owner

Phone

(562) 988-0040

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516579200000",
    "number": "1932300944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 E ATHERTON ST",
            "address_2": "SUITE 416",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154016",
            "telephone_number": "562-988-0040",
            "fax_number": "562-988-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 E ATHERTON ST",
            "address_2": "SUITE 416",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908154016",
            "telephone_number": "562-988-0040",
            "fax_number": "562-988-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST ENDOCRINE A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2018-01-22",
        "status": "A",
        "authorized_official_last_name": "CONNELLY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-988-0040",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": "CA",
            "license": "W17025",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "W17025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Endocrinology, Diabetes & Metabolism Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Endocrinology, Diabetes & Metabolism Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; 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.