Provider Demographics
NPI:1407383227
Name:ALL HEALTH ALLIANCE MEDICAL GROUP,INC
Entity Type:Organization
Organization Name:ALL HEALTH ALLIANCE MEDICAL GROUP,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MINISTRY
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEAN KITYUE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-315-5929
Mailing Address - Street 1:10505 VALLEY BLVD STE 238
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-3605
Mailing Address - Country:US
Mailing Address - Phone:626-315-5929
Mailing Address - Fax:
Practice Address - Street 1:10505 VALLEY BLVD STE 238
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-3605
Practice Address - Country:US
Practice Address - Phone:626-315-5929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A121472081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty