Provider Demographics
NPI:1073827242
Name:ASIAN HEALTH SERVICES
Entity Type:Organization
Organization Name:ASIAN HEALTH SERVICES
Other - Org Name:SATELLITE OF ASIAN HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-986-6830
Mailing Address - Street 1:101 8TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4707
Mailing Address - Country:US
Mailing Address - Phone:510-735-3100
Mailing Address - Fax:510-735-3299
Practice Address - Street 1:817 HARRISON STREET
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4422
Practice Address - Country:US
Practice Address - Phone:510-986-0430
Practice Address - Fax:510-986-0572
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASIAN HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-30
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140000125261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1447391719Medicaid
CA551047Medicare Oscar/Certification