Provider Demographics
NPI:1831975317
Name:ALPHA GENETICS LLC
Entity type:Organization
Organization Name:ALPHA GENETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:Y
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-614-9088
Mailing Address - Street 1:150 N SANTA ANITA AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3116
Mailing Address - Country:US
Mailing Address - Phone:626-614-9088
Mailing Address - Fax:
Practice Address - Street 1:2101 W BEVERLY BLVD STE 304
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-3951
Practice Address - Country:US
Practice Address - Phone:626-614-9088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory