Provider Demographics
NPI:1265574271
Name:HUNTINGTON BEACH MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:HUNTINGTON BEACH MEDICAL GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:714-841-2124
Mailing Address - Street 1:17752 BEACH BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6838
Mailing Address - Country:US
Mailing Address - Phone:714-841-2124
Mailing Address - Fax:714-841-2126
Practice Address - Street 1:17752 BEACH BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6838
Practice Address - Country:US
Practice Address - Phone:714-841-2124
Practice Address - Fax:714-841-2126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care