Unknown Individual – Physical Medicine & Rehabilitation Physician, NPI 1881628634

Unknown Individual is a healthcare provider. based in Long beach, California. specializing in Physical Medicine & Rehabilitation Physician. They hold a License No. G71400 (CA). The NPI Number for Unknown Individual is 1881628634

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1881628634
Phone
(562) 424-8111
Address
2840 LONG BEACH BLVD
Deactivation Date
2 October 2024

Doctor Profile

Medical School Name
ALBANY MEDICAL COLLEGE OF UNION UNIVERSITY
Secondary Phone
5624248111
Graduation Year
1989 (37 years ago)
PAC ID
0749188506
Group Practice PAC ID
5597663351
Professional Enrollment ID
I20100922000557
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Columbia Medical Bldg, 2840, Long Beach Boulevard, Willowville, Long Beach, Los Angeles County, California, 90806, United States

    SUITE 130

    LONG BEACH, CA 908061516

    Phone: (562) 424-8111

    Fax: (562) 492-6830

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $71.

Total Amount is formed as General ($71) + Research ($0) + Ownership ($0) = $71.

Last reported payment date: 2024-03-18 • Largest payer in this snapshot: Merz Pharmaceuticals, LLC ($37).

Total Amount

$71

General + Research + Ownership

Payments

3

Total payment records

General Amount

$71

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99215Established patient office or other outpatient visit, 40-54 minutes3029$0
View full utilization report →

Insurance plans in this area (ZIP 90806)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5597663351View full group profile
NameSpecialtyState
Physical Medicine And RehabilitationCA
Physical Medicine And Rehabilitation, Family Practice, Pain ManagementCA
Physical Medicine And RehabilitationCA
Physical Medicine And RehabilitationCA
Physical Medicine And RehabilitationCA
Pain Management, Physical Medicine And RehabilitationCA

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1881628634 if you need a stable reference for Unknown Individual.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Physical Medicine & Rehabilitation Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location shows for Unknown Individual?
We surface Long Beach, California for Unknown Individual based on available NPPES addresses.
What if Long Beach, California seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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