| KP Medical Center | |
|
888 Morada Pl Altadena CA 91001-2425 | |
| (626) 696-3692 | |
| Not Available |
| Full Name | KP Medical Center |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 888 Morada Pl, Altadena, California |
| Authorized Official Name and Position | Khalida a Pathan (PHYSICIAN/SOLE PROPRIETOR) |
| Authorized Official Contact | 6266963692 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| KP Medical Center 888 Morada Pl Altadena CA 91001-2425 Ph: (626) 696-3692 | KP Medical Center 888 Morada Pl Altadena CA 91001-2425 Ph: (626) 696-3692 |
| NPI Number | 1205287208 |
|---|---|
| Provider Enumeration Date | 06/30/2016 |
| Last Update Date | 04/30/2021 |
| Certification Date | 04/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205287208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| 261QP3300X | Clinic/center - Pain | () | Secondary |
| 305R00000X | Preferred Provider Organization | A97589 (California) | Secondary |
Alex Fridman, M.D., a Professional Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 747 E Altadena Dr, Altadena, CA 91001 Phone: 818-570-2640 Fax: 425-305-4713 |