1255465274 NPI number — ALMA FAMILY SERVICES

Table of content: (NPI 1255465274)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255465274 NPI number — ALMA FAMILY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALMA FAMILY SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ALMA FAMILY SERVICES WALNUT OP
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1255465274
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 CORPORATE CENTER DR STE 350
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTEREY PARK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91754-7620
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-526-4016
Provider Business Mailing Address Fax Number:
323-526-4096

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18780 AMAR RD
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
WALNUT
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91789-4560
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-965-4463
Provider Business Practice Location Address Fax Number:
626-965-9240
Provider Enumeration Date:
03/14/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CARACOZA
Authorized Official First Name:
MARIA DE LOURDES
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
323-526-4016

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7019 . This is a "MEDI-CAL PROVIDER NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".