Provider Demographics
NPI:1689237158
Name:ALTAMIRANO, ARTURO ANGEL (MEDICAL ASSISTANT)
Entity type:Individual
Prefix:
First Name:ARTURO
Middle Name:ANGEL
Last Name:ALTAMIRANO
Suffix:
Gender:M
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 BEYER BLVD STE E-101
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-3432
Mailing Address - Country:US
Mailing Address - Phone:619-428-5533
Mailing Address - Fax:619-428-5535
Practice Address - Street 1:3025 BEYER BLVD STE E101
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-3432
Practice Address - Country:US
Practice Address - Phone:619-428-5533
Practice Address - Fax:619-428-5535
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker