Provider Demographics
NPI:1881656460
Name:PAMC LTD PACIFIC ALLIANCE MEDICAL CENTER
Entity Type:Organization
Organization Name:PAMC LTD PACIFIC ALLIANCE MEDICAL CENTER
Other - Org Name:PACIFIC ALLIANCE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHI-YIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-830-6507
Mailing Address - Street 1:531 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-2315
Mailing Address - Country:US
Mailing Address - Phone:213-624-8411
Mailing Address - Fax:213-617-9203
Practice Address - Street 1:531 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-2315
Practice Address - Country:US
Practice Address - Phone:213-624-8411
Practice Address - Fax:213-617-9203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA930000054282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT40018GMedicaid
CAHSC30018GMedicaid
CAZZT30018GMedicaid
CAZZT40018GMedicaid
CA050018Medicare ID - Type UnspecifiedINPATINET & OUTPATIENT
CAHSC30018GMedicaid