1346350758 NPI number — AMERIWEST MEDICAL ASSOCIATES INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346350758 NPI number — AMERIWEST MEDICAL ASSOCIATES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERIWEST MEDICAL ASSOCIATES 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:
Provider Other Organization Name Type Code:
6
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:
1346350758
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1930 WILSHIRE BLVD
Provider Second Line Business Mailing Address:
STE 1100
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90057-3605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
213-483-2620
Provider Business Mailing Address Fax Number:
213-483-7918

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11850 FIRESTONE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWALK
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90650-2979
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-465-0139
Provider Business Practice Location Address Fax Number:
562-465-0138
Provider Enumeration Date:
08/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JAYASINGHE
Authorized Official First Name:
WALTER
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
562-465-0139

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  A52549 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: A31911 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: A38978 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: NP349926 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VG0400X , with the licence number: A26210 , 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: GR0060932 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".