Provider Demographics
NPI:1861181216
Name:HEALTH SERVICE ALLIANCE
Entity type:Organization
Organization Name:HEALTH SERVICE ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-281-5800
Mailing Address - Street 1:10837 LAUREL ST STE 204
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-7657
Mailing Address - Country:US
Mailing Address - Phone:909-244-9268
Mailing Address - Fax:909-244-0987
Practice Address - Street 1:10837 LAUREL ST STE 204
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7657
Practice Address - Country:US
Practice Address - Phone:909-244-9268
Practice Address - Fax:909-244-0987
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH SERVICE ALLIANCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty