Provider Demographics
NPI:1477982296
Name:SGVC
Entity Type:Organization
Organization Name:SGVC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ALONZO
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:626-444-9000
Mailing Address - Street 1:11046 VALLEY MALL
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2617
Mailing Address - Country:US
Mailing Address - Phone:626-444-9000
Mailing Address - Fax:626-444-9044
Practice Address - Street 1:11046 VALLEY MALL
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2617
Practice Address - Country:US
Practice Address - Phone:626-444-9000
Practice Address - Fax:626-444-9044
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CALIFORNIA HISPANIC COMMISSION ON ALCOHOL AND DRUG ABUSE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0298610OtherMEDICAL