Organization
ALTA SALUD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE VILLAGOMEZ MD (PRESIDENT)
(310) 398-6706
Entity
Organization
Contact information
Practice address
12099 W WASHINGTON BLVD STE 412, LOS ANGELES, CA 90066-2620
(310) 398-6706
(310) 398-5189
Mailing address
12099 W WASHINGTON BLVD STE 412, LOS ANGELES, CA 90066-2620
(310) 398-6706
(310) 398-5189
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
09/11/2025
Last updated
09/11/2025
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