Provider Demographics
NPI:1669475570
Name:OCEANVIEW PAIN TREATMENT MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:OCEANVIEW PAIN TREATMENT MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:W
Authorized Official - Last Name:HUTCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-900-1371
Mailing Address - Street 1:4543 E ANAHEIM ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3119
Mailing Address - Country:US
Mailing Address - Phone:562-900-1371
Mailing Address - Fax:562-494-0047
Practice Address - Street 1:2650 ELM AVE
Practice Address - Street 2:# 216
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1651
Practice Address - Country:US
Practice Address - Phone:562-424-2900
Practice Address - Fax:562-424-3200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical