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Organization
ALTA CALIFORNIA MEDICAL GROUP, INC.
Active
Organization
ALTA CALIFORNIA MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERTO JOSE ODIO M.D. (PRESIDENT)
(805) 578-9620
Entity
Organization
Contact information
Practice address
2755 ALAMO ST STE 201, SIMI VALLEY, CA 93065-1311
(805) 578-9620
(805) 955-0498
Mailing address
2925 SYCAMORE DR, SUITE 204-205, SIMI VALLEY, CA 93065-1207
(805) 578-9620
(805) 955-0498
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3270701
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W14981
MEDICARE PTAN
—
Enumeration date
08/09/2006
Last updated
11/24/2023
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