Provider Demographics
NPI:1205440617
Name:FRONTIDA HEALTH LLC
Entity type:Organization
Organization Name:FRONTIDA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-300-9055
Mailing Address - Street 1:1501 SUPERIOR AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3640
Mailing Address - Country:US
Mailing Address - Phone:949-484-4100
Mailing Address - Fax:949-484-4150
Practice Address - Street 1:1501 SUPERIOR AVE STE 202
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3640
Practice Address - Country:US
Practice Address - Phone:949-484-4100
Practice Address - Fax:949-791-8602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty