Provider Demographics
NPI:1750696308
Name:ALLIED HEALTH SOLUTIONS MEDICAL GROUP A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ALLIED HEALTH SOLUTIONS MEDICAL GROUP A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-944-0949
Mailing Address - Street 1:6333 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 411
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5702
Mailing Address - Country:US
Mailing Address - Phone:323-944-0949
Mailing Address - Fax:323-782-0388
Practice Address - Street 1:6333 WILSHIRE BLVD
Practice Address - Street 2:SUITE 411
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5702
Practice Address - Country:US
Practice Address - Phone:323-944-0949
Practice Address - Fax:323-782-0388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-06
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG53815261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA52606Medicare UPIN