1366769051 NPI number — ALTUS HEALTH INC.

Table of content: (NPI 1366769051)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366769051 NPI number — ALTUS HEALTH INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALTUS HEALTH INC.
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:
BRIGHTSTAR
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:
1366769051
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
151 N SUNRISE AVE STE 1011
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROSEVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95661-2930
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-781-6500
Provider Business Mailing Address Fax Number:
916-781-6568

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
151 N SUNRISE AVE STE 1011
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROSEVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95661-2930
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-781-6500
Provider Business Practice Location Address Fax Number:
916-781-6568
Provider Enumeration Date:
04/21/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CESPEDES
Authorized Official First Name:
E.
Authorized Official Middle Name:
IGNACIO
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
916-781-6500

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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