ALTAMED HEALTH SERVICES CORP (NPI# 1952532384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952532384 |
| Entity Type | Organization |
| Organization Name | ALTAMED HEALTH SERVICES CORP |
| Other Organization Name | ALTAMED PACE-GRAND PLAZA |
| Practice Address |
701 W Cesar E Chavez Ave Suite 201 Los Angeles CA 90012-2104 |
| Mailing Address |
2040 Camfield Avenue Los Angeles CA 90040-1501 |
| Practice Telephone | 2132175300 |
| Practice Fax Number | 2132175396 |
| Mailing Telephone | 3236222429 |
| Mailing Fax Number | 3238897399 |
| Enumeration Date | 2009-08-03 |
| Last Update Date | 2019-08-22 |
| Authorized Official Name | ROBERT U. YOUNG (VP, PATIENT FINANCIAL SERVICE) |
| Authorized Official Telephone | 3236222429 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251T00000X | PACE Provider Organization | Agencies |
| Other Name | Type Code |
|---|---|
| AltaMed PACE-Grand Plaza | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871116574 | Altamed Health Services Corp | Pharmacy | 1300 S Sunset Ave Rm 100, West Covina, CA 91790-3342 | 2020-05-28 |
| 1487277174 | Altamed Health Services Corp | Pharmacy | 6336 Passons Blvd Rm 100, Pico Rivera, CA 90660-3355 | 2020-05-28 |
| 1275156960 | Altamed Health Services Corp | Pharmacy | 1900 E Slauson Ave Rm 100, Huntington Park, CA 90255-2725 | 2020-05-28 |
| 1538782230 | Altamed Health Services Corp | Pharmacy | 3945 Whittier Blvd Rm 100, Los Angeles, CA 90023-2440 | 2020-05-28 |
| 1700405701 | Altamed Health Services Corp | Pharmacy | 972 Goodrich Blvd Rm 100, Los Angeles, CA 90022 | 2020-04-10 |
| 1720607997 | Altamed Health Services Corp | Pharmacy | 8627 Atlantic Ave Rm 100, South Gate, CA 90280-3501 | 2020-04-08 |
| 1942836424 | Altamed Health Services Corp | Pharmacy | 2720 S Bristol St Rm 100, Santa Ana, CA 92704-6207 | 2020-03-17 |
| 1356975239 | Altamed Health Services Corp | Pharmacy | 1325 N Anaheim Blvd, Suite 102, Anaheim, CA 92801-1202 | 2020-02-28 |
| 1609409077 | Altamed Health Services Corp | Pharmacy | 2100 W 3rd St Ste 190, Los Angeles, CA 90057-1999 | 2020-02-13 |
| 1902453731 | Altamed Health Services Corp | Clinic/Center | 2100 W 3rd St Ste 400, Los Angeles, CA 90057-2290 | 2019-08-26 |
| 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 |
701 W CESAR E CHAVEZ AVE SUITE 201 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90012-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790999373 | Altamed Health Services Corp | Clinic/Center | 701 W Cesar E Chavez Ave, Ste 201, Los Angeles, CA 90012-2104 | 2007-05-10 |
| 1104425867 | Bonnie Ruth Santillo | Registered Nurse | 701 W Cesar E Chavez Ave, Los Angeles, CA 90012-2104 | 2020-10-22 |
| 1932673290 | Laura Michael Munoz | Licensed Vocational Nurse | 701 W Cesar E Chavez Ave, Los Angeles, CA 90012-2104 | 2019-01-18 |
| 1194237883 | Raul Nungaray Jr. | Licensed Vocational Nurse | 701 W Cesar E Chavez Ave, Los Angeles, CA 90012-2104 | 2017-11-02 |
| 1679090807 | Sara Felix | Social Worker | 701 W Cesar E Chavez Ave, Los Angeles, CA 90012-2104 | 2017-08-28 |
| 1124473962 | Jeniffer Alvarez Salazar | Case Manager/Care Coordinator | 701 W Cesar E Chavez Ave, 201, Los Angeles, CA 90012-2104 | 2016-04-29 |
| 1396163267 | Brian Gordon Wong | Pharmacist | 701 W Cesar E Chavez Ave, Los Angeles, CA 90012-2104 | 2014-03-28 |
| 1407279540 | Shu Liu | Dietitian, Registered | 701 W Cesar E Chavez Ave, Suite 201, Los Angeles, CA 90012-2104 | 2014-01-24 |
| 1811338122 | Ru Wu | Social Worker | 701 W Cesar E Chavez Ave, Los Angeles, CA 90012-2104 | 2013-07-15 |
| 1164867263 | Magdalene Lui | Case Manager/Care Coordinator | 701 W Cesar E Chavez Ave, Suite 201, Los Angeles, CA 90012-2104 | 2013-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538654124 | Los Angeles County Children and Families First - Proposition 10 Commis | Case Management | 750 N. Alameda Street, Suite 300, Los Angeles, CA 90012 | 2018-06-26 |
| 1750886511 | Pain Control Clinic | Acupuncturist | 321 E. 1st St. #220, Los Angeles, CA 90012 | 2018-03-26 |
| 1891224325 | Brenda D Sazo | Community Health Worker | 1000 N. Alameda St, # 350, Los Angeles, CA 90012 | 2017-06-08 |
| 1740719012 | Fatemeh Arabpour | Dentist | 505 N Figueroa Apt #534, Los Angeles, CA 90012 | 2017-06-08 |
| 1033667662 | Olga Witrago | Case Manager/Care Coordinator | 701 W Cersar Chavez Suite 201, Los Angeles, CA 90012 | 2016-09-12 |
| 1902269962 | Samantha Martinez | Licensed Practical Nurse | 701 West Cesar Chavez Av, Los Angeles, CA 90012 | 2016-03-29 |
| 1760847313 | Maria Emilia Manosa Rosales | Social Worker | 701 W. Cesar Chavez Ave., Los Angeles, CA 90012 | 2015-12-28 |
| 1609242999 | Hilary Adams | Psychologist | 250 E 1st St Ste 300, Los Angeles, CA 90012 | 2015-08-20 |
| 1831586288 | Thanh Ngoc Nguyen Trinh | Nurse Practitioner | 180 N Los Angeles St, Los Angeles, CA 90012 | 2015-04-23 |
| 1760880827 | Bertha Regina Garcia | Licensed Vocational Nurse | 701 W. Cesar E. Chavez Ave Suite201, Los Angeles, CA 90012 | 2014-12-05 |
| Find all providers in zip 90012 | ||||
| Taxonomy Code | 251T00000X |
| Grouping | Agencies |
| Classification | PACE Provider Organization |
| A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
| Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346534443 | Remah Health Services, Inc. | PACE Provider Organization | 1524 E 103rd St, Los Angeles, CA 90002-3307 | 2011-06-06 |
| 1215113964 | Complete Care Community Health Center, Inc | PACE Provider Organization | 2928 E Cesar E Chavez Ave, Los Angeles, CA 90033-3110 | 2008-01-11 |
| 1407278393 | Altamed Health Services Corp | PACE Provider Organization | 1776 E Century Blvd, Los Angeles, CA 90002-3050 | 2014-01-10 |
| 1184835530 | Altamed Health Services Corp. | PACE Provider Organization | 5425 Pomona Blvd, Los Angeles, CA 90022-1716 | 2007-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871191932 | One Family Health Enterprise | PACE Provider Organization | 206 E 185th St, Carson, CA 90746-1706 | 2020-10-12 |
| 1003445073 | North East Medical Services | PACE Provider Organization | 728 Pacific Ave Ste 201, San Francisco, CA 94133-4449 | 2020-04-02 |
| 1508422775 | Tri Starr Home Care LLC | PACE Provider Organization | 1669 Flanigan Dr., Unit H, San Jose, CA 95121 | 2019-05-14 |
| 1669037362 | Medrev | PACE Provider Organization | 558 Chelsea Way, Corona, CA 92879-5880 | 2019-05-08 |
| 1164980439 | Tri Starr Home Care, LLC | PACE Provider Organization | 1609 Flanigan Dr., Unit H, Unit H, San Jose, CA 95122 | 2019-03-06 |
| 1063988384 | Sequoia Pace, LLC. | PACE Provider Organization | 1649 Van Ness Ave, Fresno, CA 93721-1128 | 2018-10-15 |
| 1457838955 | La Coast Pace, LLC | PACE Provider Organization | 1220 E 4th St, Long Beach, CA 90802-1831 | 2018-07-26 |
| 1194202697 | Pacific Pace, LLC | PACE Provider Organization | 50 Alessandro Pl Ste A20, Pasadena, CA 91105-3149 | 2018-07-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1063901767 | Humboldt Mobile Massage, Inc | PACE Provider Organization | 1737 Margaret Ln, Arcata, CA 95521-6838 | 2018-05-08 |
| Find all providers with the same taxonomy | ||||
| City | LOS ANGELES |
| Zip Code | 90012 |
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| 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.