Provider Demographics
NPI:1891433470
Name:INFUSION FOR HEALTH, P.C.
Entity Type:Organization
Organization Name:INFUSION FOR HEALTH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR OF PAYER CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:CLEMENTE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-269-4146
Mailing Address - Street 1:135 S STATE COLLEGE BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5814
Mailing Address - Country:US
Mailing Address - Phone:805-505-7757
Mailing Address - Fax:805-413-9099
Practice Address - Street 1:9351 GRANT ST STE 110
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4364
Practice Address - Country:US
Practice Address - Phone:805-505-7757
Practice Address - Fax:805-413-9099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion TherapyGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty