Provider Demographics
NPI:1659546927
Name:ALTAMED HEALTH SERVICES CORP
Entity Type:Organization
Organization Name:ALTAMED HEALTH SERVICES CORP
Other - Org Name:ALTAMED MEDICAL MONTEBELLO
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO, VP FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-725-8751
Mailing Address - Street 1:500 CITADEL DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90040-1575
Mailing Address - Country:US
Mailing Address - Phone:323-725-8751
Mailing Address - Fax:323-889-7843
Practice Address - Street 1:2321 W WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3006
Practice Address - Country:US
Practice Address - Phone:323-724-5232
Practice Address - Fax:323-724-5233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health