Provider Demographics
NPI:1144716663
Name:HEALTH ATLAST LONG BEACH
Entity type:Organization
Organization Name:HEALTH ATLAST LONG BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:562-706-0865
Mailing Address - Street 1:2221 PALO VERDE AVE STE 1J
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-2360
Mailing Address - Country:US
Mailing Address - Phone:562-795-7007
Mailing Address - Fax:
Practice Address - Street 1:2221 PALO VERDE AVE #1J
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-9081
Practice Address - Country:US
Practice Address - Phone:562-795-7007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-09
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Multi-Specialty