Provider Demographics
NPI:1861426058
Name:VALERIUS MEDICAL GROUP & RESEARCH CTR OF GREATER LONG BEACH, INC
Entity type:Organization
Organization Name:VALERIUS MEDICAL GROUP & RESEARCH CTR OF GREATER LONG BEACH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-989-2374
Mailing Address - Street 1:PO BOX 21299
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90801-4299
Mailing Address - Country:US
Mailing Address - Phone:562-989-2374
Mailing Address - Fax:562-989-2364
Practice Address - Street 1:2840 LONG BEACH BLVD
Practice Address - Street 2:STE 365
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1516
Practice Address - Country:US
Practice Address - Phone:562-989-2374
Practice Address - Fax:562-989-2364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W16904Medicare ID - Type Unspecified