Provider Demographics
NPI:1154414852
Name:ASSURED HEALTH CARE, INC.
Entity type:Organization
Organization Name:ASSURED HEALTH CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:K
Authorized Official - Last Name:HAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-474-8666
Mailing Address - Street 1:408 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-1002
Mailing Address - Country:US
Mailing Address - Phone:619-474-8666
Mailing Address - Fax:619-474-3025
Practice Address - Street 1:408 W 8TH ST
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-1002
Practice Address - Country:US
Practice Address - Phone:619-474-8666
Practice Address - Fax:619-474-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QU0200X, 261QU0200X
CAG024691261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20713OtherREGISTERED PHYSICAL THER.
CAA42341Medicare UPIN