Healthcare Provider Details

I. General information

NPI: 1164963666
Provider Name (Legal Business Name): THE ALDER CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2017
Last Update Date: 03/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24300 EL TORO RD BUILDING A
LAGUNA WOODS CA
92637-2737
US

IV. Provider business mailing address

24300 EL TORO RD BUILDING A
LAGUNA WOODS CA
92637-2737
US

V. Phone/Fax

Practice location:
  • Phone: 949-457-2275
  • Fax: 949-457-2265
Mailing address:
  • Phone: 949-457-2275
  • Fax: 949-457-2265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number550003811
License Number StateCA

VIII. Authorized Official

Name: MS. KAWON LEE
Title or Position: PRESIDENT/ADMINISTRATOR
Credential:
Phone: 714-512-0016