Healthcare Provider Details
I. General information
NPI: 1184504292
Provider Name (Legal Business Name): ALTAMED HEALTH SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9406 WASHINGTON BLVD
PICO RIVERA CA
90660-3913
US
IV. Provider business mailing address
2040 CAMFIELD AVE
LOS ANGELES CA
90040-1501
US
V. Phone/Fax
- Phone: 562-294-0454
- Fax: 562-295-5585
- Phone: 888-499-9303
- Fax: 562-295-5585
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
ROBERT
UY
YOUNG
Title or Position: VP, PATIENT FINANCIAL SERVICES
Credential:
Phone: 323-622-2429