# ALTA SALUD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467333732
- **Authorized official:** JOSE VILLAGOMEZ MD (PRESIDENT)
- **Authorized official phone:** (310) 398-6706

## Contact information

- **Practice address:** 12099 W WASHINGTON BLVD STE 412, LOS ANGELES, CA 90066-2620
- **Practice address phone:** (310) 398-6706
- **Practice address fax:** (310) 398-5189
- **Mailing address:** 12099 W WASHINGTON BLVD STE 412, LOS ANGELES, CA 90066-2620
- **Mailing address phone:** (310) 398-6706
- **Mailing address fax:** (310) 398-5189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/11/2025
- **Last updated:** 09/11/2025