| Alliance Health Clinic Inc | |
|
5952 El Cajon Blvd San Diego CA 92115-3828 | |
| (619) 229-8030 | |
| (619) 229-8031 |
| Full Name | Alliance Health Clinic Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5952 El Cajon Blvd, San Diego, California |
| Authorized Official Name and Position | Walter S. Lam (PRESIDENT & CEO) |
| Authorized Official Contact | 6192869052 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Health Clinic Inc 5952 El Cajon Blvd San Diego CA 92115-3828 Ph: (619) 229-8030 | Alliance Health Clinic Inc 5952 El Cajon Blvd San Diego CA 92115-3828 Ph: (619) 229-8030 |
| NPI Number | 1043413321 |
|---|---|
| Provider Enumeration Date | 06/06/2007 |
| Last Update Date | 02/08/2013 |
| Medicare PECOS PAC ID | 2062500812 |
|---|---|
| Medicare Enrollment ID | O20071113000317 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043413321 | NPI | - | NPPES |
| 2007006162 | Other | CA | BUSINESS TAX CERTIFICATE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PENDING (California) | Primary |
| Provider Name | Suzanne E Afflalo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023166931 PECOS PAC ID: 3173694551 Enrollment ID: I20080611000867 |
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