Provider Demographics
NPI:1801432257
Name:PEDIATRIC ENDOCRINOLOGY ASSOCIATES OF LONG BEACH
Entity type:Organization
Organization Name:PEDIATRIC ENDOCRINOLOGY ASSOCIATES OF LONG BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PABLITO
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:NAGPALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-743-2838
Mailing Address - Street 1:126 N DEERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-4579
Mailing Address - Country:US
Mailing Address - Phone:619-838-4194
Mailing Address - Fax:
Practice Address - Street 1:2650 ELM AVE STE 210
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1600
Practice Address - Country:US
Practice Address - Phone:562-595-0166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric EndocrinologyGroup - Single Specialty