Provider Demographics
NPI:1689492167
Name:HEALTH SERVICE ALLIANCE
Entity type:Organization
Organization Name:HEALTH SERVICE ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:J
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-464-9675
Mailing Address - Street 1:16377 MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-3567
Mailing Address - Country:US
Mailing Address - Phone:760-688-4808
Mailing Address - Fax:760-688-4816
Practice Address - Street 1:16377 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-3567
Practice Address - Country:US
Practice Address - Phone:760-688-4808
Practice Address - Fax:760-688-4816
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH SERVICE ALLIANCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty