Provider Demographics
NPI:1710970728
Name:CARSON MCBEATH & BOSWELL INC.
Entity Type:Organization
Organization Name:CARSON MCBEATH & BOSWELL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-984-7024
Mailing Address - Street 1:4300 LONG BEACH BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2011
Mailing Address - Country:US
Mailing Address - Phone:562-984-7024
Mailing Address - Fax:562-428-7394
Practice Address - Street 1:4300 LONG BEACH BLVD
Practice Address - Street 2:STE 300
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2011
Practice Address - Country:US
Practice Address - Phone:562-984-7024
Practice Address - Fax:562-428-7394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W5462Medicare ID - Type Unspecified