Provider Demographics
NPI:1811543325
Name:AFFINITY HEALTH PARTNERS, INC.
Entity Type:Organization
Organization Name:AFFINITY HEALTH PARTNERS, INC.
Other - Org Name:AVANT RX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAQUICHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTERVELT
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:949-351-1044
Mailing Address - Street 1:1100 S COAST HWY STE 214
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-2975
Mailing Address - Country:US
Mailing Address - Phone:949-715-4418
Mailing Address - Fax:949-715-4419
Practice Address - Street 1:1100 S COAST HWY STE 214
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-2975
Practice Address - Country:US
Practice Address - Phone:949-715-4418
Practice Address - Fax:949-715-4419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-12
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty