Basic Information
| Provider Information | |||||||||
| NPI: | 1881615789 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEONATAL MEDICAL ASSOCIATES | ||||||||
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| OtherOrganizationName: | NEONATAL MEDICAL ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 17459 | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908077459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629338100 | ||||||||
| FaxNumber: | 5629338014 | ||||||||
| Practice Location | |||||||||
| Address1: | 2801 ATLANTIC AVE | ||||||||
| Address2: | 2ND FLOOR, NICU | ||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908061701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629338100 | ||||||||
| FaxNumber: | 5629338140 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2006 | ||||||||
| LastUpdateDate: | 09/04/2008 | ||||||||
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| AuthorizedOfficialLastName: | PADILLA | ||||||||
| AuthorizedOfficialFirstName: | GUADALUPE | ||||||||
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| AuthorizedOfficialTitleorPosition: | SR PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 5629338100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080N0001X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
No ID Information.