MEDICARE: ALTAMED HEALTH SERVICES CORPORATION

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	171M00000X	Case Manager/Care Coordinator		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124234505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTAMED HEALTH SERVICES CORPORATION

Provider Business Mailing Address
First Line	:	6210 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-4506
Country	:	US
Telephone Number	:	323-888-2887
Fax Number	:	323-888-2889

Provider Business Practice Location Address
First Line	:	6210 WHITTIER BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90022-4506
Country	:	US
Telephone Number	:	323-888-2887
Fax Number	:	323-888-2889

Authorized Official
Title or Position	:	AVP LTC, ADHC ADMINISTRATOR
Name	:	MR. CRAIG MICHAEL SANTY
Credential	:
Telephone Number	:	213-217-5300

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	08/22/2020

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Directions to “ALTAMED HEALTH SERVICES CORPORATION ” Practice Location

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