NPI 1164713590

Champion Medical Group, a Medical Corporation

Organisation Non-Pharmacy Dispensing Site Long Beach, CA

Practice location

Address: 2777 Pacific Ave STE K, Long Beach, CA 90806-2625
Phone: (562) 989-5712
Mailing address: 2980 N Beverly Glen Cir Suite 100, Los Angeles, CA 90077-1726

Authorised official

Name: Herbert Marshak
Title: Medical Director
Phone: (562) 989-5712

Registered specialties

Non-Pharmacy Dispensing Site Primary

Suppliers Taxonomy 332900000X

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Registry record

NPI: 1164713590
Entity type: Organization
NPI issued: 19 Apr 2011
Record last updated: 5 Oct 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.