Basic Information
| Provider Information | |||||||||
| NPI: | 1801932108 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALTAMED MEDICAL AND DENTAL GROUP BOYLE HEIGHTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5948 OLIVE AVE | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908053517 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232651998 | ||||||||
| FaxNumber: | 3232651948 | ||||||||
| Practice Location | |||||||||
| Address1: | 3945 WHITTIER BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900232440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3232651998 | ||||||||
| FaxNumber: | 3232651948 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ARREDONDO | ||||||||
| AuthorizedOfficialFirstName: | ANGELA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CLINIC ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 3232651998 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MISS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0050X | Y | Ambulatory Health Care Facilities | Clinic/Center | Family Planning, Non-Surgical |
No ID Information.