NPIMap

Organization Active NPI

Altamed Health Services Corp

Doing business as AltaMed Pharmacy South Gate

  • Community/Retail Pharmacy
  • South Gate, CA
National Provider Identifier
1720607997
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ALTAMED HEALTH SERVICES CORP
Doing business as
AltaMed Pharmacy South Gate
Practice address
8627 Atlantic Ave RM 100
South Gate, CA 90280-3501
Phone
(888) 499-9303
Fax
(323) 853-6935
NPI assigned
Apr 8, 2020
Last updated
Apr 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

8627 Atlantic Ave RM 100
South Gate, CA 90280-3501

Mailing address

2040 Camfield Ave
Los Angeles, CA 90040
Phone (323) 622-2429

Other names 1

  • AltaMed Pharmacy South Gate Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200827003907 CA Part B Supplier - Pharmacy 4284539966 9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Covina, CA; South Gate, CA; Santa Ana, CA; Pico Rivera, CA; Huntington Park, CA; Los Angeles, CA; Huntington Beach, CA; Anaheim, CA…

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Altamed Health Ser117 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

Locations

8627 Atlantic Ave
Rm 100
South Gate, CA 90280

NPI Registry JSON

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586304000000",
    "number": "1720607997",
    "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": "90040",
            "telephone_number": "323-622-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8627 ATLANTIC AVE RM 100",
            "city": "SOUTH GATE",
            "state": "CA",
            "postal_code": "902803501",
            "telephone_number": "888-499-9303",
            "fax_number": "323-853-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTAMED HEALTH SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-08",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AltaMed Pharmacy South Gate",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Gate, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.