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NPI Code Detail

MEDICARE: CROWN CITY ADHC, INC.

MEDICARE: CROWN CITY ADHC, INC.
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
1171W00000XContractorCA

Other Identifiers

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

General Provider Information

NPI Number : 1972719185
Entity Type Code : Organization
Provider Name (Legal Business Name) : CROWN CITY ADHC, INC.
Provider Business Mailing Address
First Line : 122 N EL MOLINO AVE
Second Line :
City : PASADENA
State : CA
Zip : 91101-1805
Country : US
Telephone Number : 626-583-8822
Fax Number : 626-583-8844
Provider Business Practice Location Address
First Line : 122 N EL MOLINO AVE
Second Line :
City : PASADENA
State : CA
Zip : 91101-1805
Country : US
Telephone Number : 626-583-8822
Fax Number : 626-583-8844
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. ALEX LEO STEINE
Credential : MBA
Telephone Number : 626-583-8822
Provider Enumeration Date : 05/15/2007
Last Update Date : 09/25/2007

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Directions to “CROWN CITY ADHC, INC. ” Practice Location

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