Healthcare Provider Details

I. General information

NPI: 1952532384
Provider Name (Legal Business Name): ALTAMED HEALTH SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2009
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W CESAR E CHAVEZ AVE SUITE 201
LOS ANGELES CA
90012-2104
US

IV. Provider business mailing address

2040 CAMFIELD AVENUE
LOS ANGELES CA
90040-1501
US

V. Phone/Fax

Practice location:
  • Phone: 213-217-5300
  • Fax: 213-217-5396
Mailing address:
  • Phone: 323-622-2429
  • Fax: 323-889-7399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: ROBERT U. YOUNG
Title or Position: VP, PATIENT FINANCIAL SERVICE
Credential: MD
Phone: 323-622-2429