Healthcare Provider Details

I. General information

NPI: 1043489958
Provider Name (Legal Business Name): ALTAMED HEALTH SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 05/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2223 W 1ST ST
SANTA ANA CA
92703-3505
US

IV. Provider business mailing address

500 CITADEL DR SUITE 490
LOS ANGELES CA
90040-1575
US

V. Phone/Fax

Practice location:
  • Phone: 714-500-0320
  • Fax: 323-889-7843
Mailing address:
  • Phone: 323-725-8751
  • Fax: 323-889-7843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSE ESPARZA
Title or Position: VP FINANCE, CFO
Credential:
Phone: 323-725-8751