Provider Demographics
NPI:1952434250
Name:PREMIER MEDICAL CARE, INC.
Entity Type:Organization
Organization Name:PREMIER MEDICAL CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNY
Authorized Official - Middle Name:PO-SHENG
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-424-2008
Mailing Address - Street 1:2840 LONG BEACH BLVD.
Mailing Address - Street 2:SUITE 408
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-7512
Mailing Address - Country:US
Mailing Address - Phone:562-424-2008
Mailing Address - Fax:
Practice Address - Street 1:2840 LONG BEACH BLVD.
Practice Address - Street 2:SUITE 408
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-7512
Practice Address - Country:US
Practice Address - Phone:562-424-2008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ08622ZOtherBLUE SHIELD GROUP ID#
CAW16645BMedicare ID - Type UnspecifiedGROUP ID#
CAZZZ08622ZOtherBLUE SHIELD GROUP ID#