12310 Lower Azusa Rd,

LBN: 12310 Lower Azusa Rd,
12310 Lower Azusa Rd, is an health care organization with primary practice located at 12310 Lower Azusa Ave , Arcadia CA 91006. The organization recently has only one registered license in Agencies / Case Management, which is considered as the primary health care specialty. 12310 Lower Azusa Rd, can be contacted via phone (626) 579-8593, or through Fortson, Kyle via phone (626) 579-8593.

Contact Information

Primary practice address
12310 Lower Azusa Ave Arcadia CA 91006
Phone: (626) 579-8593
Fax: (562) 433-1029
Website:
Map and Directions
Authorized official contact:
Name: Fortson, Kyle
Phone: (626) 579-8593

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X

Profile Details

NPI number 1174813299
LBN Legal business name 12310 Lower Azusa Rd,
DBA Doing business as
Authorized official Fortson, Kyle
Entity Organization
Organization subpart 1 No
Enumeration date Apr 11th, 2011
Last updated Apr 11th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174813299 NPPES
California Other 171M00000X CASE MANAGER/CARE COORDINATOR

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