Provider Demographics
NPI:1093006512
Name:ARCH HEALTH PARTNERS
Entity Type:Organization
Organization Name:ARCH HEALTH PARTNERS
Other - Org Name:ARCH HEALTH PARTNERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-675-3100
Mailing Address - Street 1:PO BOX 51739
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-6039
Mailing Address - Country:US
Mailing Address - Phone:858-613-8900
Mailing Address - Fax:858-618-1523
Practice Address - Street 1:15525 POMERADO RD
Practice Address - Street 2:SUTE C-1
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2435
Practice Address - Country:US
Practice Address - Phone:858-485-7870
Practice Address - Fax:858-485-6473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80210207Y00000X
CAAU 2545231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADD294AMedicare PIN