MEDICARE: ALTAMED HEALTH SERVICES CORP.

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	261QA0600X	Adult Day Care Clinic/Center	ADUF0117F	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	:	1205030848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTAMED HEALTH SERVICES CORP.

Provider Business Mailing Address
First Line	:	500 CITADEL DR STE 490
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90040-1589
Country	:	US
Telephone Number	:	323-889-7349
Fax Number	:	323-889-7843

Provider Business Practice Location Address
First Line	:	6330 RUGBY AVE STE 200
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4066
Country	:	US
Telephone Number	:	323-227-7678
Fax Number	:	323-277-7686

Authorized Official
Title or Position	:	DIRECTOR, CLIENT SERVICES
Name	:	MR. PETER M FELDMAN
Credential	:	MFT
Telephone Number	:	323-889-7349

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	08/22/2020

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Directions to “ALTAMED HEALTH SERVICES CORP. ” Practice Location

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