Healthcare Provider Details

I. General information

NPI: 1851324206
Provider Name (Legal Business Name): ALHAMBRA FAMILY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 03/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1336 W. VALLEY BLVD, #A
ALHAMBRA CA
91803-3257
US

IV. Provider business mailing address

1336 W. VALLEY BLVD, #A
ALHAMBRA CA
91803-3257
US

V. Phone/Fax

Practice location:
  • Phone: 626-281-2232
  • Fax: 626-281-7214
Mailing address:
  • Phone: 626-281-2232
  • Fax: 626-281-7214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JACQUELINE WONG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 626-281-2232