NPIMap

Organization Active NPI

Altamed Health Services Corp

  • PACE Provider Organization
  • Lynwood, CA
National Provider Identifier
1982990859
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PACE Provider OrganizationTaxonomy code 251T00000X
Legal business name
ALTAMED HEALTH SERVICES CORP
Practice address
3820 Martin Luther King Jr Blvd
Lynwood, CA 90262-3625
Phone
(310) 632-0415
Fax
(310) 639-2734
NPI assigned
Jun 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 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
PACE Provider Organization 251T00000X Primary

Addresses

Primary practice location

3820 Martin Luther King Jr Blvd
Lynwood, CA 90262-3625

Mailing address

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

Other names 1

  • AltaMed PACE-Lynwood Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1010064Altamed Pace - Lynwood3820 Martin Luther King Jr Blvd, Lynwood, CA 90262Certificate of waiverMar 4, 2027

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567036800000",
    "number": "1982990859",
    "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": "323-889-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 MARTIN LUTHER KING JR BLVD",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623625",
            "telephone_number": "310-632-0415",
            "fax_number": "310-639-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTAMED HEALTH SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-20",
        "last_updated": "2019-08-29",
        "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": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AltaMed PACE-Lynwood",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AltaMed PACE-Lynwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.