Provider Demographics
NPI:1043640063
Name:CARDIN HEALTHCARE, A MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:CARDIN HEALTHCARE, A MEDICAL GROUP, INC.
Other - Org Name:LONG BEACH PEDIATRIC CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:CARDIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:562-492-9900
Mailing Address - Street 1:2880 ATLANTIC AVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1714
Mailing Address - Country:US
Mailing Address - Phone:562-492-9900
Mailing Address - Fax:562-492-9902
Practice Address - Street 1:2880 ATLANTIC AVE STE 170
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1715
Practice Address - Country:US
Practice Address - Phone:562-492-9900
Practice Address - Fax:562-492-9902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No171W00000XOther Service ProvidersContractorGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health