MEDICARE: ALMA CARE HEALTH GROUP

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	207RC0000X	Cardiovascular Disease Physician	G48891	CA

General Provider Information

NPI Number	:	1336380765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALMA CARE HEALTH GROUP

Provider Business Mailing Address
First Line	:	11278 LOS ALAMITOS BLVD
Second Line	:	SUITE 250
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3958
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11278 LOS ALAMITOS BLVD
Second Line	:	SUITE 250
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3958
Country	:	US
Telephone Number	:	562-256-6481
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ALAN K JACOBSON
Credential	:
Telephone Number	:	562-256-6481

Provider Enumeration Date	:	03/14/2009
Last Update Date	:	08/06/2009

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