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California State University, Long Beach — NPI 1780930990, Long Beach, CA | NPI Central

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NPI 1780930990

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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)

Practice location

3640 E 17th St

Long Beach, CA 90804-2001

Phone: (562) 209-2861

More CA providers

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.