Provider Demographics
NPI:1225232739
Name:GB MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:GB MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BENEDICTA
Authorized Official - Middle Name:NGOZI
Authorized Official - Last Name:ILOUNO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:310-897-1478
Mailing Address - Street 1:3505 LONG BEACH BLVD
Mailing Address - Street 2:SUITE 1F
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3907
Mailing Address - Country:US
Mailing Address - Phone:310-897-1478
Mailing Address - Fax:562-988-3439
Practice Address - Street 1:3505 LONG BEACH BLVD
Practice Address - Street 2:SUITE 1F
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3907
Practice Address - Country:US
Practice Address - Phone:310-897-1478
Practice Address - Fax:562-988-3439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA499233251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management