ST. MARY MEDICAL CENTER (NPI# 1285007419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285007419 |
| Entity Type | Organization |
| Organization Name | ST. MARY MEDICAL CENTER |
| Practice Address |
1045 Atlantic Ave Suite 914 Long Beach CA 90813-3408 |
| Practice Telephone | 5626244977 |
| Mailing Telephone | 5626244977 |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2015-11-10 |
| Authorized Official Name | MARICA ALCOULOUMRE (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 5626244900 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | CA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669456299 | St. Mary Medical Center | General Acute Care Hospital | 18300 Highway 18, Apple Valley, CA 92307 | 2005-12-06 |
| 1740698497 | St. Mary Medical Center | General Acute Care Hospital | 1707 N Henderson St, Galesburg, IL 61401-1320 | 2014-07-25 |
| 1487078796 | St. Mary Medical Center | Ambulance | 1201 Langhorne Newtown Rd, Langhorne, PA 19047-1201 | 2014-02-06 |
| 1043406440 | St. Mary Medical Center | Advanced Practice Midwife | 18077 Us Highway 18, Apple Valley, CA 92307-2150 | 2007-09-19 |
| 1982899266 | St. Mary Medical Center | General Acute Care Hospital | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2007-09-11 |
| 1700921541 | St. Mary Medical Center | Internal Medicine | 2241 45th St, Highland, IN 46322-2601 | 2007-02-20 |
| 1952458564 | St. Mary Medical Center | Nurse Anesthetist, Certified Registered | 1500 S Lake Park Ave, Hobart, IN 46342-6638 | 2007-01-04 |
| 1457425605 | St. Mary Medical Center | Internal Medicine | 300 W 80th Pl, Ste A, Merrillville, IN 46410-5456 | 2006-11-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ST. MARY MEDICAL CENTER | 1201 Langhorne - Newtown Rd, Langhorne, PA 19047-1201 |
| Washington State Corporations | ST. MARY MEDICAL CENTER | 401 W Poplar St, Walla Walla, WA 99362 |
| Indiana Business Entities | ST. MARY MEDICAL CENTER DEVELOPMENT, LLC | St. Mary Medical Center, 1500 S. Lake Park Ave., Hobart, IN 46342 |
| System for Award Management (SAM) Entities | ST. MARY MEDICAL CENTER FOUNDATION | 1050 Linden Ave, Long Beach, CA 90813-3321 |
| System for Award Management (SAM) Entities | ST. MARY MEDICAL CENTER, INC. | 1500 S Lake Park Ave, Hobart, IN 46342-6638 |
| Street Address |
1045 ATLANTIC AVE SUITE 914 |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90813-3408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841294733 | Merrill M Knopf | Ophthalmology | 1045 Atlantic Ave, Ste 1007, Long Beach, CA 90813-3413 | 2005-06-08 |
| 1760928329 | Ps Ahuja Dental Corp | Dentist | 1045 Atlantic Ave, Ste 602, Long Beach, CA 90813-3408 | 2017-01-06 |
| 1821448028 | Cardiovascular Innovation and Research Center Inc | Internal Medicine | 1045 Atlantic Ave, Suite 611, Long Beach, CA 90813-3408 | 2016-06-17 |
| 1508289158 | Healthy Foundations Medical Group | Pediatrics | 1045 Atlantic Ave, Ste 715, Long Beach, CA 90813-3408 | 2014-01-31 |
| 1649513961 | American Pacific Medical Group Inc | Internal Medicine | 1045 Atlantic Ave, Suite 902, Long Beach, CA 90813-3408 | 2013-04-04 |
| 1235436023 | Janet Do | Pediatrics | 1045 Atlantic Ave, #605, Long Beach, CA 90813-3408 | 2011-02-15 |
| 1578864211 | Amar S Kapoor M D Inc | Internal Medicine | 1045 Atlantic Ave, Suite 611, Long Beach, CA 90813-3408 | 2010-11-11 |
| 1063720324 | Coreen Marie Correa | Nurse Practitioner | 1045 Atlantic Ave, 508, Long Beach, CA 90813-3408 | 2010-09-21 |
| 1790002236 | Michael O Liff Md Inc | Internal Medicine | 1045 Atlantic Ave, Suite 902, Long Beach, CA 90813-3408 | 2010-04-23 |
| 1053637959 | Joanna Ai Wan Tan | Internal Medicine | 1045 Atlantic Ave, Suite 708, Long Beach, CA 90813-3408 | 2010-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861018491 | Marisol Zobler | Social Worker | 820 Long Beach Bvld, Long Beach, CA 90813 | 2020-06-19 |
| 1437787009 | Cho Rok Kim | Student in an Organized Health Care Education/Training Program | Graduate Medical Education, 1050 Linden Ave., Long Beach, CA 90813 | 2020-03-30 |
| 1316407596 | Vicky Sandhu | Student in an Organized Health Care Education/Training Program | Graduate Medical Education, 1050 Linden Ave, Long Beach, CA 90813 | 2019-03-22 |
| 1245734912 | Madiha Naseem | Internal Medicine | Graduate Medical Education, 1050 Linden Avenue, Long Beach, CA 90813 | 2018-03-19 |
| 1689194508 | Naomi Ruiz | Specialist/Technologist | 838 Pine Ave Apt. 314, Long Beach, CA 90813 | 2017-06-21 |
| 1851831531 | Tyler Lappen | Student in an Organized Health Care Education/Training Program | 830 Atlantic Ave., Long Beach, CA 90813 | 2017-03-01 |
| 1639628886 | Assavuth Kim | Community Health Worker | 1471 Cherry Avenue, Long Beach, CA 90813 | 2016-09-29 |
| 1881031300 | Stacy Nicole Delgado-willis | Marriage & Family Therapist | 851 Pine Ave Ste 103, Long Beach, CA 90813 | 2013-05-23 |
| 1740623453 | Paula Ann Di Thomas | Nurse Practitioner | 1043 Elm Ave #104, Long Beach, CA 90813 | 2013-04-11 |
| 1629322722 | David O Chavez | Case Manager/Care Coordinator | 820 Long Beach Blvd, Long Beach, CA 90813 | 2012-10-29 |
| Find all providers in zip 90813 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235772609 | Belmont Shore Wellness Center | Clinic/Center | 5237 E 2nd St, Long Beach, CA 90803-5326 | 2019-10-17 |
| 1699316349 | New Life Community Mental Health Center | Clinic/Center | 1040 Elm Ave Ste 208, Long Beach, CA 90813-3266 | 2019-10-03 |
| 1326557828 | Broderick Chiropractic Corporation | Clinic/Center | 3816 Woodruff Ave Ste 202, Long Beach, CA 90808-2145 | 2017-09-27 |
| 1912372517 | Richard Kaplan | Clinic/Center | 2235 Vuelta Grande Ave, Long Beach, CA 90815-2354 | 2015-12-08 |
| 1669812392 | The Roads Foundation, Inc | Clinic/Center | 4800 E Los Coyotes Diagonal, Long Beach, CA 90815-2827 | 2013-06-26 |
| 1336443548 | Chok P Wan Md Inc | Clinic/Center | 2153 Pacific Ave, Long Beach, CA 90806-4513 | 2011-01-03 |
| 1962642892 | Van Thuan Phat | Clinic/Center | 825 E Anaheim St, Long Beach, CA 90813-3550 | 2009-03-05 |
| 1053566224 | South Medical Clinic | Clinic/Center | 1530 E. South Street, Long Beach, CA 90805 | 2008-12-01 |
| 1568629103 | West Coast Orthopedics Inc | Clinic/Center | 3325 Palo Verde, Suite 205, Long Beach, CA 90808 | 2008-05-21 |
| 1073703252 | Special Service for Groups | Clinic/Center | 2501 Atlantic Ave, Long Beach, CA 90806-2708 | 2007-07-25 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90813 |
Please comment or provide details below to improve the information on ST. MARY MEDICAL CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.