Organization
ALLIANCE HEALTHCARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA KASSA (SR VICE PRESIDENT)
(904) 300-2777
Entity
Organization
Contact information
Practice address
2500 MOWRY AVE, SUITE 170, FREMONT, CA 94538
(510) 608-1380
Mailing address
8300 W SUNRISE BLVD, PLANTATION, FL 33322-5406
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
6640-30
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EXE70092F
—
CA
01
—
ZZZ08999Z
BLUE SHIELD OF CA
CA
01
—
ZZZ55650Z
BLUE SHIELD OF CA
CA
Enumeration date
11/29/2006
Last updated
07/24/2023
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