Provider Demographics
NPI:1053523142
Name:FIVE ACES HEALTH CARE CORPORATION
Entity type:Organization
Organization Name:FIVE ACES HEALTH CARE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALDRIN
Authorized Official - Middle Name:HALABASO
Authorized Official - Last Name:FESTEJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-581-4034
Mailing Address - Street 1:18800 AMAR RD
Mailing Address - Street 2:SUITE D-5
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-4166
Mailing Address - Country:US
Mailing Address - Phone:626-581-4034
Mailing Address - Fax:626-581-1356
Practice Address - Street 1:18800 AMAR RD
Practice Address - Street 2:SUITE D-5
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-4166
Practice Address - Country:US
Practice Address - Phone:626-581-4034
Practice Address - Fax:626-581-1356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA060000731261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care