Provider Demographics
NPI:1700010865
Name:VA LONG BEACH MEDICAL CENTER
Entity Type:Organization
Organization Name:VA LONG BEACH MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PHARMACIST
Authorized Official - Prefix:MS
Authorized Official - First Name:OK
Authorized Official - Middle Name:H
Authorized Official - Last Name:YOON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:562-826-8000
Mailing Address - Street 1:5901 E. 7TH ST.,
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90822
Mailing Address - Country:US
Mailing Address - Phone:562-826-8000
Mailing Address - Fax:562-826-5282
Practice Address - Street 1:5901 E. 7TH ST.,
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90822
Practice Address - Country:US
Practice Address - Phone:562-826-8000
Practice Address - Fax:562-826-5282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA40024282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1508962853OtherCLINICAL PHARMACIST