Provider Demographics
NPI:1154361913
Name:HOPE HEALTHCARE, A MEDICAL CORPORATION
Entity type:Organization
Organization Name:HOPE HEALTHCARE, A MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:M
Authorized Official - Last Name:AFRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-301-4041
Mailing Address - Street 1:1532 SAN BERNARDINO AVE
Mailing Address - Street 2:SUITE B7
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3559
Mailing Address - Country:US
Mailing Address - Phone:909-301-4041
Mailing Address - Fax:909-301-4042
Practice Address - Street 1:1532 SAN BERNARDINO AVE
Practice Address - Street 2:SUITE B7
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3559
Practice Address - Country:US
Practice Address - Phone:909-301-4041
Practice Address - Fax:909-301-4042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25248261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB263444OtherMEDICARE PTAN
CA6867037Medicaid
CA5204341Medicaid