ALTAMED HEALTH SERVICES CORP (NPI# 1417194259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417194259 |
| Entity Type | Organization |
| Organization Name | ALTAMED HEALTH SERVICES CORP |
| Other Organization Name | ALTAMED MEDICAL GROUP- LA CENTRAL |
| Practice Address |
2707 S Central Ave Los Angeles CA 90011-5527 |
| Practice Telephone | 3237258751 |
| Practice Fax Number | 3238897843 |
| Mailing Telephone | 3237258751 |
| Mailing Fax Number | 3238897843 |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2009-01-15 |
| Authorized Official Name | MR. JOSE ESPARZA (CFO) |
| Authorized Official Telephone | 3237258751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| AltaMed Medical Group- LA Central | Other Name - Individual/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 |
2707 S CENTRAL AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90011-5527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649292459 | Naeemah Howell Ghafur | Family Medicine | 2707 S Central Ave, Los Angeles, CA 90011-5527 | 2006-07-24 |
| 1518409432 | Caroline Mckinley | Nurse Practitioner | 2707 S Central Ave, Los Angeles, CA 90011-5527 | 2016-11-09 |
| 1548610322 | Central Neighborhood Health Foundation - Inglewood | Clinic/Center | 2707 S Central Ave, Los Angeles, CA 90011-5527 | 2016-06-13 |
| 1346640414 | Noemi G. Relampagos | Nurse Practitioner | 2707 S Central Ave, Los Angeles, CA 90011-5527 | 2014-08-26 |
| 1205269347 | Central Neighborhood Health Foundation | Clinic/Center | 2707 S Central Ave, Los Angeles, CA 90011-5527 | 2013-08-13 |
| 1225470636 | Kamala Kennetria Gipson | Nurse Practitioner | 2707 S Central Ave, Los Angeles, CA 90011-5527 | 2013-07-26 |
| 1801151964 | Elea Cho-yee Wong | Nurse Practitioner | 2707 S Central Ave, Los Angeles, CA 90011-5527 | 2012-07-05 |
| 1639453079 | Elizabeth Ngassa | Nurse Practitioner | 2707 S Central Ave, Los Angeles, CA 90011-5527 | 2011-10-04 |
| 1306133657 | Central Neighborhood Health Foundation | Clinic/Center | 2707 S Central Ave, Los Angeles, CA 90011-5527 | 2011-07-07 |
| 1235450495 | Mary Christine Deasis Gonzales | Nurse Practitioner | 2707 S Central Ave, Los Angeles, CA 90011-5527 | 2010-06-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184223935 | Commercial & Housing Support Aid | Assisted Living Facility | 120 - 122 East 24th Street, Los Angeles, CA 90011 | 2020-10-22 |
| 1295377711 | Joseph D Madrigal | Home Health Aide | 1977 Anzac Ave, Los Angeles, CA 90011 | 2019-10-16 |
| 1538641212 | Brenda Bahena | Community Health Worker | South Central Family Health Center, 4425 S. Central Ave, Los Angeles, CA 90011 | 2018-08-30 |
| 1083101851 | Bronwyn Anne Hazlewood | Student in an Organized Health Care Education/Training Program | 3740 Maple Ave, 1/2 B, Los Angeles, CA 90011 | 2018-04-17 |
| 1164941183 | Kimberly Denise Lister- Gutierrez | Counselor | 303 E 52nd Street, Los Angeles, CA 90011 | 2017-09-11 |
| 1205252533 | Jameese B Smith | Case Manager/Care Coordinator | 271 E. 43rd Street, Los Angeles, CA 90011 | 2014-03-11 |
| 1033533153 | Avalon-carver Community Center | Community/Behavioral Health | 4920 S. Avalon Blvd, Los Angeles, CA 90011 | 2014-02-10 |
| 1245672500 | Kellie D Bougard | Student in an Organized Health Care Education/Training Program | 4920 South Avalon Blvd, Los Angeles, CA 90011 | 2013-07-26 |
| 1578909404 | Ma. Jasmin F Binas | Nurse Practitioner | 2707 S.central Ave., Los Angeles, CA 90011 | 2013-05-19 |
| 1912343344 | California Assisted Pharmacy, Inc | Pharmacy | 646 E 28th St, Ste #1, Los Angeles, CA 90011 | 2013-05-13 |
| Find all providers in zip 90011 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083251532 | Prime Wellness Community Health Center | Clinic/Center | 1824 1/2 W 38th Pl, Los Angeles, CA 90062-1012 | 2019-12-03 |
| 1093278632 | St. John's Well Child and Family Center, Inc. | Clinic/Center | 1060 West Exposition Blvd., Los Angeles, CA 90007 | 2019-04-10 |
| 1003367590 | Jwch Institute, Inc | Clinic/Center | 115 E. 3rd Street, Los Angeles, CA 90013-1301 | 2016-10-19 |
| 1568919108 | Jwch Institute, Inc | Clinic/Center | 3804 Broadway Pl, Los Angeles, CA 90037-1414 | 2016-09-01 |
| 1093167850 | 3c Community Clinic | Clinic/Center | 3030 W Olympic Blvd Ste 206, Los Angeles, CA 90006-6506 | 2016-07-05 |
| 1174996177 | All-inclusive Community Health Center | Clinic/Center | 3920 Eagle Rock Blvd Ste A, Los Angeles, CA 90065-3606 | 2015-11-12 |
| 1861893844 | St. John's Well Child and Family Center, Inc. | Clinic/Center | 326 West 23rd Street, Los Angeles, CA 90007 | 2014-09-10 |
| 1649680588 | St. John's Well Child and Family Center, Inc. | Clinic/Center | 400 W Washington Blvd Bldg E-102, Los Angeles, CA 90015-4108 | 2014-04-30 |
| 1629491089 | St. John's Well Child and Family Center, Inc. | Clinic/Center | 1555 West 110th St, Los Angeles, CA 90047-1220 | 2014-01-21 |
| 1487086989 | Central Neighborhood Health Foundation | Clinic/Center | 2614 S Grand Ave, Los Angeles, CA 90007-2607 | 2013-08-07 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90011 |
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.