Altamed Sbc Pace East Los Angeles

NPI 1083823488 - Clinic/Center - 261Q00000X

NPI Details
NPI 1083823488
Enumeration Date 05/22/2007
Last Updated 04/26/2012
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MICHAEL E. MICHAEL
Position MEDICAL DIRECTOR, INNOVATION
Phone (617) 407-9515
Fax
Practice Location
5425 POMONA BLVD
LOS ANGELES CA, 90022-1716, US
Phone (617) 407-9515
Fax
Business Location
5425 POMONA BLVD
LOS ANGELES CA, 90022-1716, US
Phone (617) 407-9515
Fax
Toxanomy
Taxonomy Code 261Q00000X
License State California
License Number A107932
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According to our database, Altamed Sbc Pace East Los Angeles NPI is 1083823488, taxonomy code is 261Q00000X and license number is A107932, license state is located at California. Altamed Sbc Pace East Los Angeles physically located at 5425 Pomona Blvd, Los Angeles CA, 90022-1716. NPI Number 1033115704 has the healthcare provider type.

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1083823488 NPI number is provided on an as is basis without warranty of any kind. 1083823488 is maintained by the National Plan & Provider Enumeration System. The contents of Altamed Sbc Pace East Los Angeles are for informational purposes only.