ATLANTIC UROLOGY MEDICAL GROUP INC
NPI 1467649764
Specialist in Long Beach, CA
- Organization
- Specialist
- CLIA Number: 05D0554349
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-20-2026
About ATLANTIC UROLOGY MEDICAL GROUP INC
This page provides the complete NPI Profile along with additional information for Atlantic Urology Medical Group Inc, a provider established in Long Beach, California operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1467649764 assigned on October 2007. The practitioner's primary taxonomy code is 174400000X with license number A32052 (CA). The provider is registered as an organization and their NPI record was last updated 7 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Wendy Solis (Office Manager)
- NPI
- 1467649764 Verify this NPI
- Provider Name
- ATLANTIC UROLOGY MEDICAL GROUP INC
- Entity Type
- Organization
- Location Address
- 701 E 28TH ST SUITE 319 LONG BEACH, CA 90806
- Location Phone
- (562) 595-5977
- Location Fax
- (562) 490-0509
- Mailing Address
- 701 E 28TH ST SUITE 319 LONG BEACH, CA 90806
- Mailing Phone
- (562) 595-5977
- Mailing Fax
- (562) 490-0509
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-01-2007
- Last Update Date
- 08-27-2019
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- A32052
- License State
- CA
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| W9927 | OTHER (01) | CA | MEDICARE ID |
| 2405716 | MEDICAID (05) | CA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0554349
- Facility Type
- Physician Office
- Certificate Effective Date
- October 21, 2024
- Certificate Expiration Date
- October 20, 2026
- Laboratory Director
- BARTON H. WACHS MD
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Atlantic Urology Medical Group Inc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
LONG BEACH, CA 90806
LONG BEACH, CA 90806
LONG BEACH, CA 90806
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1467649764, enumerated as an "organization" on October 01, 2007.
The provider is located at 701 E 28TH ST SUITE 319 LONG BEACH, CA 90806 and the phone number is (562) 595-5977.
Specialist with taxonomy code 174400000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
