1568493922 NPI number — LOS ALAMITOS MEDICAL CENTER, INC.

Table of content: (NPI 1568493922)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568493922 NPI number — LOS ALAMITOS MEDICAL CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOS ALAMITOS MEDICAL CENTER, 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:
LOS ALAMITOS MEDICAL CENTER
Provider Other Organization Name Type Code:
3
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:
1568493922
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
FILE 57484
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90074-7484
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-300-4122
Provider Business Mailing Address Fax Number:
562-493-2812

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3751 KATELLA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ALAMITOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90720-3101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-598-1311
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/05/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROBEY
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
562-799-3528

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  060000142 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: HSP40551H , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 050551B000000 . This is a "SECTION 1011" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8202 . This is a "HEALTH NET" identifier . This identifiers is of the category "OTHER".
  • Identifier: HSC30551H , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 002733-0001 . This is a "PACIFICARE OF CALIFORNIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 443786740 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000406 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: ZZZA3017Z . This is a "BS OF CALIFORNIA" identifier . This identifiers is of the category "OTHER".