Healthcare Provider Details

I. General information

NPI: 1780463752
Provider Name (Legal Business Name): ALTAMED HEALTH SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2023
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 N FAIR OAKS AVE STE 200
PASADENA CA
91103-1620
US

IV. Provider business mailing address

2040 CAMFIELD AVE
LOS ANGELES CA
90040-1501
US

V. Phone/Fax

Practice location:
  • Phone: 626-398-6300
  • Fax: 323-853-6923
Mailing address:
  • Phone: 888-499-9303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ROBERT UY YOUNG
Title or Position: VP, PATIENT FINANCIAL SERVICES
Credential:
Phone: 323-622-2429