NPIMap

Organization Active NPI

Altamed Health Services Corp

Doing business as AltaMed Medical Group - West Covina, Amar

  • Federally Qualified Health Center (FQHC)
  • West Covina, CA
National Provider Identifier
1992590301
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ALTAMED HEALTH SERVICES CORP
Doing business as
AltaMed Medical Group - West Covina, Amar
Practice address
1536 E Amar Rd
West Covina, CA 91792-1618
Phone
(626) 214-7442
Fax
(626) 214-7443
NPI assigned
Apr 14, 2025
Last updated
Apr 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1536 E Amar Rd
West Covina, CA 91792-1618

Mailing address

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

Other names 1

  • AltaMed Medical Group - West Covina, Amar Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251117002469 CA Part A Provider - Federally Qualified Health Center (FQHC) 4284539966 Practice locations: West Covina, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992590301. Details of each certification follow.

Federally qualified health center certification: CCN A11015

Legal name
ALTAMED HEALTH SERVICES CORP
Doing business as
ALTAMED MEDICAL GROUP - WEST COVINA, AMAR
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 8, 2025
Last certification
Oct 8, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1536 E Amar Rd
West Covina, CA 91792-1618

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 22

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
05D2327470Altamed Medical Group-West Covina, Amar1536 E Amar Rd, West Covina, CA 91792Certificate of waiverJul 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Altamed Senior Clinic117 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

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

Locations

1536 E Amar Rd
West Covina, CA 91792
Phone (626) 214-7442

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Maria Grimaldo Individual Corporate DirectorConsumer Board Member Oct 29, 2013
Jose Avalos Individual Corporate DirectorChair, Board Member Jun 28, 2018
Robert Rodriguez Individual Corporate DirectorConsumer Board Member Jan 1, 2024
Castulo de la Rocha Individual Corporate OfficerPresident and Ceo Mar 1, 1997
Marc Victor Individual Corporate DirectorBoard Member Oct 26, 2017
Ricardo Robles Individual Corporate DirectorSecretary, Consumer Board Member Jan 22, 2015
Victor Olmos Individual Corporate DirectorTreasurer, Board Member Oct 23, 2020
Jay P Lee Individual Corporate DirectorBoard Member Jan 1, 2024
Maria Cervantes Individual Corporate DirectorBoard Member Jun 28, 2018
Joseph Gomez Individual Corporate DirectorConsumer Board Member Sep 6, 2019
Jose Ubaldo Esparza Individual Corporate OfficerEvp Finance and Cfo Jan 6, 2012
Robert Young Individual W-2 Managing EmployeeVice President, PFS Jan 6, 2012
Nadia Paola Alvarez Individual Corporate DirectorConsumer Board Member Sep 6, 2019
Lucy Maria Herrera Individual Corporate DirectorVice Chair, Consumer Board Member Nov 5, 2019

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1992590301",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 E AMAR RD",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921618",
            "telephone_number": "626-214-7442",
            "fax_number": "626-214-7443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTAMED HEALTH SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "VP, PATIENT FINANCIAL SERVICES",
        "authorized_official_telephone_number": "323-622-2429",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AltaMed Medical Group - West Covina, Amar",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.