Organization
ALTAMED HEALTH SERVICES CORP
Active
Other names
AltaMed Medical and Dental Group-South Gate
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT U. YOUNG MD (VP. PATIENT FINANCIAL SERVICES)
(323) 622-2429
Entity
Organization
Contact information
Practice address
8627 ATLANTIC AVE, SOUTH GATE, CA 90280-3501
(323) 312-2625
(323) 312-2984
Mailing address
2040 CAMFIELD AVE, LOS ANGELES, CA 90040-1501
(323) 725-8751
(323) 889-7399
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTL5426
MEDICAL BOARD OF CALIFORNIA
CA
Enumeration date
03/11/2016
Last updated
02/07/2022
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