Healthcare Provider Details

I. General information

NPI: 1992525497
Provider Name (Legal Business Name): ALTAMED HEALTH SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2024
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 S GLENDORA AVE
WEST COVINA CA
91790-4205
US

IV. Provider business mailing address

2040 CAMFIELD AVENUE
LOS ANGELES CA
90040-1501
US

V. Phone/Fax

Practice location:
  • Phone: 626-214-3850
  • Fax: 626-486-9693
Mailing address:
  • Phone: 888-499-9303
  • Fax: 323-888-0220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State

VIII. Authorized Official

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