Provider Demographics
NPI:1033607296
Name:HEALTH ATLAST LONG BEACH
Entity Type:Organization
Organization Name:HEALTH ATLAST LONG BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-795-7007
Mailing Address - Street 1:2221 PALO VERDE AVE STE 1J
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-2360
Mailing Address - Country:US
Mailing Address - Phone:562-795-7007
Mailing Address - Fax:
Practice Address - Street 1:2221 PALO VERDE AVE STE 1J
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-2360
Practice Address - Country:US
Practice Address - Phone:562-795-7007
Practice Address - Fax:562-795-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty