Healthcare Provider Details

I. General information

NPI: 1568827210
Provider Name (Legal Business Name): ALTURA CENTERS FOR HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2015
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 W TULARE DR
TULARE CA
93274-3424
US

IV. Provider business mailing address

1134 E CARTMILL AVE
TULARE CA
93274
US

V. Phone/Fax

Practice location:
  • Phone: 559-686-9097
  • Fax: 559-556-0083
Mailing address:
  • Phone: 559-686-9097
  • Fax: 559-556-0083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: GRACIELA SOTO PEREZ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 559-685-4601