Healthcare Provider Details
I. General information
NPI: 1346414612
Provider Name (Legal Business Name): ATLAMED HEALTH SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/17/2008
Last Update Date: 08/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6336 PASSONS BLVD
PICO RIVERA CA
90660-3355
US
IV. Provider business mailing address
2040 CAMFIELD AVE
LOS ANGELES CA
90040-1501
US
V. Phone/Fax
- Phone: 562-949-6069
- Fax: 562-949-0199
- Phone: 323-725-8751
- Fax: 323-889-7843
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
U.
YOUNG
Title or Position: AVP, PATIENT FINANCIAL SERVICES
Credential: M.D.
Phone: 323-622-2429