NPIMap

Organization Active NPI

Altamed Health Services Corp

Doing business as AltaMed PACE-Grand Plaza

  • PACE Provider Organization
  • Los Angeles, CA
National Provider Identifier
1952532384
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
ALTAMED HEALTH SERVICES CORP
Doing business as
AltaMed PACE-Grand Plaza
Practice address
701 W Cesar E Chavez Ave
Suite 201
Los Angeles, CA 90012-2104
Phone
(213) 217-5300
Fax
(213) 217-5396
NPI assigned
Aug 3, 2009
Last updated
Aug 22, 2019By the provider in NPPES
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 Service
Phone
(323) 622-2429

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X NU Primary

Addresses

Primary practice location

701 W Cesar E Chavez Ave
Suite 201
Los Angeles, CA 90012-2104

Mailing address

2040 Camfield Avenue
Los Angeles, CA 90040-1501
Phone (323) 622-2429

Other names 1

  • AltaMed PACE-Grand Plaza Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1952532384. Details of each certification follow.

  • CCN 751833 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 751833

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ALTAMED PACE - GRAND PLAZA
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 5, 2016
Last certification
Jan 5, 2016
Ownership / control type
For profit – corporation
Facility address
701 Cesar E Chavez Ave
Los Angeles, CA 90012

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1249257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1952532384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 CAMFIELD AVENUE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900401501",
            "telephone_number": "323-622-2429",
            "fax_number": "323-889-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W CESAR E CHAVEZ AVE",
            "address_2": "SUITE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122104",
            "telephone_number": "213-217-5300",
            "fax_number": "213-217-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTAMED HEALTH SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-03",
        "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 SERVICE",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AltaMed PACE-Grand Plaza",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AltaMed PACE-Grand Plaza",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.