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Organization
ALTAMED
Active
Organization
ALTAMED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASTULO DE LA ROCHA JD (CEO)
(877) 462-2582
Entity
Organization
Contact information
Practice address
535 S 2ND AVE, COVINA, CA 91723-3013
(626) 214-1484
Mailing address
2040 CAMFIELD AVE, COMMERCE, CA 90040-1502
(323) 725-8751
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
847492
CA
Other
Enumeration date
07/31/2015
Last updated
07/31/2015
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