NPIMap

Organization Active NPI

Altamed Health Services Corp

Doing business as AltaMed Medical Group -Senior Buena Care/Pomona

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
National Provider Identifier
1083800098
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
FHC70488F Issued in CA
Legal business name
ALTAMED HEALTH SERVICES CORP
Doing business as
AltaMed Medical Group -Senior Buena Care/Pomona
Practice address
5425 Pomona Blvd
Los Angeles, CA 90022-1716
Phone
(323) 728-0411
Fax
(323) 728-1535
NPI assigned
Sep 24, 2007
Last updated
Aug 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robert U. Young, M.D.
Title
VP, Patient Financial Services
Phone
(323) 622-2429

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X FHC70488F CA Primary

Addresses

Primary practice location

5425 Pomona Blvd
Los Angeles, CA 90022-1716

Mailing address

2040 Camfield Ave
Los Angeles, CA 90040-1501
Phone (323) 725-8751

Other identifiers 2

IdentifierTypeStateIssuer
W49430OtherCAUHIC
FHC70488FMedicaidCA

Other names 1

  • AltaMed Medical Group -Senior Buena Care/Pomona Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565913600000",
    "number": "1083800098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 CAMFIELD AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900401501",
            "telephone_number": "323-725-8751",
            "fax_number": "323-889-7843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 POMONA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221716",
            "telephone_number": "323-728-0411",
            "fax_number": "323-728-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTAMED HEALTH SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2019-08-16",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "U.",
        "authorized_official_title_or_position": "VP, PATIENT FINANCIAL SERVICES",
        "authorized_official_telephone_number": "323-622-2429",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "FHC70488F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHIC",
            "identifier": "W49430",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC70488F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AltaMed Medical Group -Senior Buena Care/Pomona",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AltaMed Medical Group -Senior Buena Care/Pomona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.