Provider Demographics
NPI:1336747013
Name:ADVANCED HEALTHCARE ADMINISTRATION
Entity Type:Organization
Organization Name:ADVANCED HEALTHCARE ADMINISTRATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:V
Authorized Official - Last Name:MONCADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-565-3529
Mailing Address - Street 1:4800 GAGE AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:BELL
Mailing Address - State:CA
Mailing Address - Zip Code:90201-1425
Mailing Address - Country:US
Mailing Address - Phone:562-565-3529
Mailing Address - Fax:668-200-6794
Practice Address - Street 1:4800 GAGE AVE STE 4
Practice Address - Street 2:
Practice Address - City:BELL
Practice Address - State:CA
Practice Address - Zip Code:90201-1425
Practice Address - Country:US
Practice Address - Phone:213-306-8129
Practice Address - Fax:866-200-6794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or CharitableGroup - Single Specialty