Provider Demographics
NPI:1215382817
Name:BUSINESS HEALTH AFFILIATES
Entity Type:Organization
Organization Name:BUSINESS HEALTH AFFILIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUDWIG
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:415-328-3456
Mailing Address - Street 1:3031 STANFORD RANCH RD
Mailing Address - Street 2:# 2-448
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5554
Mailing Address - Country:US
Mailing Address - Phone:415-328-3456
Mailing Address - Fax:
Practice Address - Street 1:3031 STANFORD RANCH RD
Practice Address - Street 2:# 2-448
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5554
Practice Address - Country:US
Practice Address - Phone:415-328-3456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center