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CH09311AG ALTAMED HEALTH SERVICES CORPORATION (Terminated)
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Main Details
Name
ALTAMED HEALTH SERVICES CORPORATION
Subdivision Name
AltaMed Medical Group at Hollywood Presbyterian Medical Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-012567
340B ID
CH09311AG
Grant Number
H80CS00142
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/7/2013
Last Recertification Date
2/10/2020
Termination Date
Termination Reason
4/1/2020
Site closure
Contacts
Authorizing Official
AltaMed Health Services Corporation
Jose Esparza, Sr. VP, Finance & CFO
(323) 889-7320
Primary Contact
AltaMed Health Services Corporation
Israel Espinoza, Care Management Coordinator
(323) 889-7886
Addresses
Street Address
1300 North Vermont Avenue, Patient Tower, First Floor
Los Angeles, CA 90027
Billing Address
AltaMed Health Services Corporation
2040 Camfield Avenue
Los Angeles, CA 90040
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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