Provider Demographics
NPI:1679973085
Name:ALTAMED MEDICAL GROUP
Entity Type:Organization
Organization Name:ALTAMED MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SANGEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALVI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:323-307-0419
Mailing Address - Street 1:9 FRANCISCAN PL
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-4867
Mailing Address - Country:US
Mailing Address - Phone:951-454-3355
Mailing Address - Fax:
Practice Address - Street 1:3945 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023-2440
Practice Address - Country:US
Practice Address - Phone:323-307-0419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70064183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty