Provider Demographics
NPI:1013025600
Name:ALASKA FAMILY CARE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ALASKA FAMILY CARE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:LEIH-SHENG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-929-5888
Mailing Address - Street 1:4001 DALE STREET
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5445
Mailing Address - Country:US
Mailing Address - Phone:907-929-5888
Mailing Address - Fax:907-929-5882
Practice Address - Street 1:4001 DALE STREET
Practice Address - Street 2:SUITE 210
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5445
Practice Address - Country:US
Practice Address - Phone:907-929-5888
Practice Address - Fax:907-929-5882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK152556Medicare PIN