Provider Demographics
NPI:1558038521
Name:ALTA MIRA HEALTH INC
Entity Type:Organization
Organization Name:ALTA MIRA HEALTH INC
Other - Org Name:ALTA MIRA URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:JASWANT
Authorized Official - Middle Name:G
Authorized Official - Last Name:VIRK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-515-9194
Mailing Address - Street 1:3033 EL CAMINO AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95821-6014
Mailing Address - Country:US
Mailing Address - Phone:916-515-9194
Mailing Address - Fax:916-515-9847
Practice Address - Street 1:3033 EL CAMINO AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-6014
Practice Address - Country:US
Practice Address - Phone:916-515-9194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care