Provider Demographics
NPI:1386998185
Name:INNOVATIVE HEALTH ACCESS, INC
Entity type:Organization
Organization Name:INNOVATIVE HEALTH ACCESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:PYUN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, PHD (ABD)
Authorized Official - Phone:818-984-3757
Mailing Address - Street 1:2258 ROSECRANS AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-1742
Mailing Address - Country:US
Mailing Address - Phone:855-926-3545
Mailing Address - Fax:
Practice Address - Street 1:2258 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-1742
Practice Address - Country:US
Practice Address - Phone:855-926-3545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management