MEDICARE: INTEGRATED SCHOOL HEATH CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1073941019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED SCHOOL HEATH CENTER

Provider Business Mailing Address
First Line	:	10155 COLIMA RD
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90603-2042
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12417 PHILADELPHIA ST
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-3933
Country	:	US
Telephone Number	:	562-692-0383
Fax Number	:

Authorized Official
Title or Position	:	C.E.O.
Name	:	CHARLENE DIMAS PEINADO
Credential	:
Telephone Number	:	562-692-0383

Provider Enumeration Date	:	10/30/2013
Last Update Date	:	10/30/2013

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Directions to “INTEGRATED SCHOOL HEATH CENTER ” Practice Location

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