Organization Name: | COMMUNITY HEALTH ALLIANCE OF PASADENA |
NPI Number: | 1063805463 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARGARET BANDA MARTINEZ (CHIEF EXECUTIVE OFFICER) |
Mailing Address: | 513 E Lime Ave Suite 101 Monrovia |
State: | CA US |
Postal Code: | 910162982 |
Phone Number: | 6267880290 |
Fax Number: | 6267880291 |
NPI Enumeration Date: | 03/09/2015 |
NPI Last Update Date: | 11/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |