Provider Demographics
NPI:1811268964
Name:TE MEDICAL CENTER, INC
Entity type:Organization
Organization Name:TE MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEANGLONG
Authorized Official - Middle Name:
Authorized Official - Last Name:TE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-376-2018
Mailing Address - Street 1:2148 E ANAHEIM ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3408
Mailing Address - Country:US
Mailing Address - Phone:562-218-4298
Mailing Address - Fax:562-218-1480
Practice Address - Street 1:2148 E ANAHEIM ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3408
Practice Address - Country:US
Practice Address - Phone:562-218-4298
Practice Address - Fax:562-218-1480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-21
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
CAA106386261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty