OrganizationActive
California State University, Long Beach
NPI 1780930990 · Point of Service · Long Beach, CA
Provider details
- NPI number
- 1780930990
- Entity type
- Organization
- Primary specialty
- Point of ServiceManaged Care Organizations
- Authorized official
- Lacey Waters, Network Manager
- License
- 436601 (CA)
Mailing address
3640 E 17th St
Long Beach, CA 90804-2001
Registry dates
- Enumerated
- 2012-07-25
- Last updated
- 2012-07-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.