Provider Demographics
NPI:1467718148
Name:ASIAN HEALTH SERVICES
Entity Type:Organization
Organization Name:ASIAN HEALTH SERVICES
Other - Org Name:ASIAN MEDICAL SERVICES AT HOTEL OAKLAND - CDP
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-986-6830
Mailing Address - Street 1:275 14TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-4070
Mailing Address - Country:US
Mailing Address - Phone:510-986-8688
Mailing Address - Fax:510-986-6885
Practice Address - Street 1:275 14TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-4070
Practice Address - Country:US
Practice Address - Phone:510-986-8688
Practice Address - Fax:510-986-6885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140000532261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1225179641Medicaid
CA1689744179OtherFQHC MEDICARE