Healthcare Provider Details

I. General information

NPI: 1003752429
Provider Name (Legal Business Name): PREMIER SENIOR HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4152 KATELLA AVE STE 201
LOS ALAMITOS CA
90720-6608
US

IV. Provider business mailing address

4152 KATELLA AVE STE 201
LOS ALAMITOS CA
90720-6608
US

V. Phone/Fax

Practice location:
  • Phone: 562-710-3240
  • Fax:
Mailing address:
  • Phone: 562-710-3240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHALANI ALBAYALDE
Title or Position: SECRETARY
Credential:
Phone: 562-710-3240