NPIMap

Organization Active NPI

Altamed Health Services Corp.

  • PACE Provider Organization
  • Los Angeles, CA
National Provider Identifier
1184835530
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
License
CMM70726F Issued in CA
Legal business name
ALTAMED HEALTH SERVICES CORP.
Practice address
5425 Pomona Blvd
Los Angeles, CA 90022-1716
Phone
(323) 728-0411
Fax
(323) 728-1535
NPI assigned
May 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X CMM70726F 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) 889-7349

Other identifiers 1

IdentifierTypeStateIssuer
CMM70726FMedicaidCA

Other names 1

  • AltaMed PACE-East Los Angeles Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Altamed Health Service Corpotation117 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1184835530",
    "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": "323-889-7349",
            "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": "2007-05-25",
        "last_updated": "2019-08-22",
        "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": "MD"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "CA",
            "license": "CMM70726F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMM70726F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AltaMed PACE-East Los Angeles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AltaMed PACE-East Los Angeles",
            "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 22, 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.