Provider Demographics
NPI:1962596775
Name:AMERICAN HEALTH ASSOCIATES, INC
Entity type:Organization
Organization Name:AMERICAN HEALTH ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-861-1478
Mailing Address - Street 1:930 OAK ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-1060
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:930 OAK ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-1060
Practice Address - Country:US
Practice Address - Phone:661-861-1478
Practice Address - Fax:661-861-9037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ65027ZOtherBLUE SHIELD OF CALIFORNIA
CA10454OtherKERN FAMILY HEALTH CARE
CAHHA08264FMedicaid
CAZZZ65027ZOtherBLUE SHIELD OF CALIFORNIA
CAZZZ65027ZOtherBLUE SHIELD OF CALIFORNIA