Advanced Health Centers, Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

ADVANCED HEALTH CENTERS, INC.

Doing business as

San Pedro ADHC

Practice address

430 W 6TH St
San Pedro, CA 90731-2632

Phone

(310) 519-9880

Fax

(310) 519-8072

NPI assigned

May 14, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Valentina V Leibzon

Title

Program Director

Phone

(310) 519-9880

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• San Pedro ADHC Doing business as

Locations

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942415690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W 6TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312632",
            "telephone_number": "310-519-9880",
            "fax_number": "310-519-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W 6TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312632",
            "telephone_number": "310-519-9880",
            "fax_number": "310-519-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEIBZON",
        "authorized_official_first_name": "VALENTINA",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "310-519-9880",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ADU70368F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Pedro ADHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Health Maintenance Organization in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.