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General NPI Number Information
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NPI Number | 1801307368
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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 | 10/23/2017
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 13193 CENTRAL AVE
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City | CHINO
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State | CA
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Zip | 91710-4179
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Country | US
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Telephone | 909-464-9675
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Fax | 909-590-3898
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Provider Business Mailing Address
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Address Line | 5050 SAN BERNARDINO ST
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City | MONTCLAIR
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State | CA
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Zip | 91763-2326
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Country | US
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Telephone | 909-281-5800
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Fax | 909-281-5858
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES LALLY
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Credential | DO
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Telephone | 909-281-5800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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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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