Provider Demographics
NPI:1821365016
Name:MINUTE CLINIC
Entity type:Organization
Organization Name:MINUTE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:DARIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHHIM
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:562-481-8205
Mailing Address - Street 1:5863 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-4160
Mailing Address - Country:US
Mailing Address - Phone:562-481-8205
Mailing Address - Fax:
Practice Address - Street 1:2900 N SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-2730
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20907363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty