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NPI Code Detail

MEDICARE: ALTAMED HEALTH SERVICES CORP

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
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1760651814
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALTAMED HEALTH SERVICES CORP
Provider Business Mailing Address
First Line : 2040 CAMFIELD AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90040-1501
Country : US
Telephone Number : 323-622-2429
Fax Number : 323-889-7843
Provider Business Practice Location Address
First Line : 2720 S BRISTOL ST
Second Line : SUITE 110
City : SANTA ANA
State : CA
Zip : 92704-6207
Country : US
Telephone Number : 714-557-4080
Fax Number : 714-557-2251
Authorized Official
Title or Position : VP, PATIENT FINANCIAL SERVICES
Name : ROBERT U. YOUNG
Credential : M.D.
Telephone Number : 323-622-2429
Provider Enumeration Date : 02/22/2008
Last Update Date : 08/16/2019

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