ALTAMED HEALTH SERVICES CORP. (NPI# 1629283197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629283197 |
| Entity Type | Organization |
| Organization Name | ALTAMED HEALTH SERVICES CORP. |
| Other Organization Name | ALTAMED GENERAL PEDIATRICS @ CHILDREN'S HOSPITAL |
| Practice Address |
4650 W Sunset Blvd Los Angeles CA 90027-6062 |
| Mailing Address |
2040 Camfield Ave Los Angeles CA 90040-1501 |
| Practice Telephone | 3236692113 |
| Practice Fax Number | 3239068003 |
| Mailing Telephone | 3238897349 |
| Mailing Fax Number | 3238897843 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2019-08-20 |
| Authorized Official Name | ROBERT U. YOUNG (VP, PATIENT FINANCIAL SERVICES) |
| Authorized Official Telephone | 3236222429 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
FHC71094F | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FHC71094F | 05 |
| Other Name | Type Code |
|---|---|
| AltaMed General Pediatrics @ Children's Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194999342 | Altamed Health Services Corp. | Clinic/Center | 10418 E. Valley Blvd, El Monte, CA 91731 | 2008-04-18 |
| 1952588691 | Altamed Health Services Corp. | Clinic/Center | 6901 Atlantic Ave, Bell, CA 90201-3646 | 2008-01-24 |
| 1477737385 | Altamed Health Services Corp. | Clinic/Center | 5425 Pomona Blvd, Los Angeles, CA 90022-1716 | 2007-12-27 |
| 1396949939 | Altamed Health Services Corp. | Clinic/Center | 3820 Martin Luther King Jr Blvd, Lynwood, CA 90262-3625 | 2007-06-14 |
| 1205030848 | Altamed Health Services Corp. | Clinic/Center | 6330 Rugby Ave Ste 200, Huntington Park, CA 90255-4066 | 2007-06-14 |
| 1023212669 | Altamed Health Services Corp. | Clinic/Center | 701 W Cesar E Chavez Ave, Los Angeles, CA 90012-2104 | 2007-06-14 |
| 1184835530 | Altamed Health Services Corp. | PACE Provider Organization | 5425 Pomona Blvd, Los Angeles, CA 90022-1716 | 2007-05-25 |
| 1679789051 | Altamed Health Services Corp. | Clinic/Center | 5000 W Sunset Blvd, Los Angeles, CA 90027-5861 | 2007-05-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ALTAMED HEALTH SERVICES CORPORATION | 2040 Camfield Avenue, Los Angeles, CA 90040-1502 |
| Street Address |
4650 W SUNSET BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90027-6062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144223926 | Fariba Navid | Pediatrics | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2005-05-24 |
| 1811596810 | Samih Samaha | Social Worker | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-10-21 |
| 1437756988 | Amanda Ruth Mendelis | Nurse Practitioner | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-10-07 |
| 1124638119 | Hayden Mensah Mbroh | Rehabilitation Counselor | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-08-04 |
| 1619587854 | Allyssa Marie Asperin Cayago | Nurse Practitioner | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-08-03 |
| 1134739592 | Alison Coombs | Physical Therapist | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-07-31 |
| 1679190482 | Jearelly Pinedo | Registered Nurse | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-06-26 |
| 1124644901 | Corey Hacker | Nurse Practitioner | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-06-17 |
| 1720602667 | Bhavna Shah | Physical Therapist | 4650 W Sunset Blvd, Mailstop # 154, Los Angeles, CA 90027 | 2020-06-06 |
| 1023632528 | Bethany L Burdick | Student in an Organized Health Care Education/Training Program | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2020-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326653593 | Lamia Binhuwaishel | Student in an Organized Health Care Education/Training Program | 4650 Sunset Blvd, Craniofacial and Special Needs Ortho, Los Angeles, CA 90027 | 2020-09-14 |
| 1285242594 | Rocio Jimenez | Case Manager/Care Coordinator | 4650 Sunset Blvd, Mailstop #53, Los Angeles, CA 90027 | 2020-07-22 |
| 1558984799 | Integrative Endodontics, Inc | Dentist | 10850 Wilshine Blvd Ste 301, Los Angeles, CA 90027 | 2020-05-22 |
| 1104450295 | Sarayana Sercarz | Marriage & Family Therapist | 4080 Woking Way, Los Angeles, CA 90027 | 2020-02-27 |
| 1457991143 | George Michaiel | Pediatrics | 4650 Sunset Blvd., Ms #54, Los Angeles, CA 90027 | 2020-01-09 |
| 1477199297 | Molly Rose Holmes | Marriage & Family Therapist | 3901 Los Feliz Boulevard, #303, Los Angeles, CA 90027 | 2019-11-27 |
| 1588206171 | Dental Help Solutions, LLC | Dentist | 4606 Hollywood Blvd, Suite A, Los Angeles, CA 90027 | 2019-10-15 |
| 1457905986 | Carmen L Ponce | Physical Therapy Assistant | 4867 Sunset Ave, Los Angeles, CA 90027 | 2019-08-01 |
| 1447729009 | Matthew Mendoza | Respiratory Therapist, Registered | 4867 Sunset Blvd, Los Angeles, Ca, Los Angeles, CA 90027 | 2018-11-13 |
| 1659856284 | Leticia Mendez | Nurse Practitioner | 1300 N Vermont Ave 606, Los Angeles, CA 90027 | 2018-09-29 |
| Find all providers in zip 90027 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1225673262 | Complete Care Community Health Center, Inc | Clinic/Center | 1300 N Vermont Ave Ste 606, Los Angeles, CA 90027-6088 | 2019-11-13 |
| 1811548712 | Jwch Institute, Inc | Clinic/Center | 1670 E 120 Street, West Support Bldg #14 Fl 2, Los Angeles, CA 90059-3026 | 2019-09-23 |
| 1902453731 | Altamed Health Services Corp | Clinic/Center | 2100 W 3rd St Ste 400, Los Angeles, CA 90057-2290 | 2019-08-26 |
| 1992269757 | Los Angeles Christian Health Centers | Clinic/Center | 325 7th Street, Los Angeles, CA 90014 | 2019-01-25 |
| 1083132849 | Altamed Health Services Corp | Clinic/Center | 2100 W 3rd St Ste 220, Los Angeles, CA 90057-1993 | 2017-08-31 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90027 |
Please comment or provide details below to improve the information on ALTAMED HEALTH SERVICES CORP..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.