Provider Demographics
NPI:1659773968
Name:ALTAMED HEALTH SERVICE CORP
Entity Type:Organization
Organization Name:ALTAMED HEALTH SERVICE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT MANGER-OC WOMEN'S HEALTH
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORREA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-426-5117
Mailing Address - Street 1:2720 S BRISTOL ST STE 110
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6210
Mailing Address - Country:US
Mailing Address - Phone:714-426-5222
Mailing Address - Fax:714-557-2251
Practice Address - Street 1:2720 S BRISTOL ST STE 110
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6210
Practice Address - Country:US
Practice Address - Phone:714-426-5222
Practice Address - Fax:714-557-2251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty