Provider Demographics
NPI:1194199109
Name:PHYSICIANS CLINICAL RESEARCH, LLC
Entity Type:Organization
Organization Name:PHYSICIANS CLINICAL RESEARCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-612-0000
Mailing Address - Street 1:2240 PACIFIC AVE STE A
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-4372
Mailing Address - Country:US
Mailing Address - Phone:562-612-0000
Mailing Address - Fax:
Practice Address - Street 1:2240 PACIFIC AVE STE A
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-4372
Practice Address - Country:US
Practice Address - Phone:562-612-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-15
Last Update Date:2015-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Single Specialty