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General NPI Number Information
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NPI Number | 1396949939
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Entity Type | Organization
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Legal Business Name | ALTAMED HEALTH SERVICES CORP.
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3820 MARTIN LUTHER KING JR BLVD
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City | LYNWOOD
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State | CA
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Zip | 90262-3625
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Country | US
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Telephone | 310-632-0415
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Fax | 310-605-5438
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Provider Business Mailing Address
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Address Line | 500 CITADEL DR STE 490
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City | LOS ANGELES
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State | CA
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Zip | 90040-1589
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Country | US
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Telephone | 323-889-7349
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Fax | 323-889-7843
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Authorized Official
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Title or Position | DIRECTOR, CLIENT SERVICES
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Name | MR. PETER M FELDMAN
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Credential | MFT
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Telephone | 323-889-7349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | ADUF0030G
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License Number State | CA
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