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General NPI Number Information
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NPI Number | 1689492167
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Entity Type | Organization
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Legal Business Name | HEALTH SERVICE ALLIANCE
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 16377 MAIN ST STE A
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City | HESPERIA
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State | CA
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Zip | 92345-3567
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Country | US
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Telephone | 760-688-4808
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Fax | 760-688-4816
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Provider Business Mailing Address
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Address Line | 16377 MAIN ST STE A
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City | HESPERIA
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State | CA
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Zip | 92345-3567
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Country | US
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Telephone | 760-688-4808
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Fax | 760-688-4816
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Authorized Official
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Title or Position | CFO
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Name | JEFFREY J COX
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Credential |
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Telephone | 909-464-9675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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