Provider Demographics
NPI:1568493922
Name:LOS ALAMITOS MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:LOS ALAMITOS MEDICAL CENTER, INC.
Other - Org Name:LOS ALAMITOS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-799-3528
Mailing Address - Street 1:FILE 57484
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-7484
Mailing Address - Country:US
Mailing Address - Phone:626-300-4122
Mailing Address - Fax:562-493-2812
Practice Address - Street 1:3751 KATELLA AVE
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3101
Practice Address - Country:US
Practice Address - Phone:562-598-1311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000142282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHSP40551HMedicaid
050551B000000OtherSECTION 1011
8202OtherHEALTH NET
CAHSC30551HMedicaid
002733-0001OtherPACIFICARE OF CALIFORNIA
443786740OtherAETNA US HEALTHCARE
000406OtherHUMANA
ZZZA3017ZOtherBS OF CALIFORNIA
CAHSC30551HMedicaid