| Health Alliance Socal, Inc | |
|
1300 N. Vermont Ave. Los Angeles CA 90027-6098 | |
| (310) 321-0143 | |
| (310) 379-4856 |
| Full Name | Health Alliance Socal, Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1300 N. Vermont Ave., Los Angeles, California |
| Authorized Official Name and Position | Anil Sharma (PRESIDENT) |
| Authorized Official Contact | 3103210143 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Alliance Socal, Inc Po Box 80718 City Of Industry CA 91716-8416 Ph: (310) 321-0143 | Health Alliance Socal, Inc 1300 N. Vermont Ave. Los Angeles CA 90027-6098 Ph: (310) 321-0143 |
| NPI Number | 1184343055 |
|---|---|
| Provider Enumeration Date | 08/24/2022 |
| Last Update Date | 04/21/2023 |
| Certification Date | 04/21/2023 |
| Medicare PECOS PAC ID | 4082082250 |
|---|---|
| Medicare Enrollment ID | O20221118000753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184343055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Anil Sharma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447328109 PECOS PAC ID: 1355313370 Enrollment ID: I20040810001288 |
| Provider Name | Austina B Cho |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780770453 PECOS PAC ID: 5991862831 Enrollment ID: I20090320000503 |
| Provider Name | Cordelia Rose E Onyekwe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194026542 PECOS PAC ID: 2163686577 Enrollment ID: I20120615000265 |
| Provider Name | Mitali Wadekar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588853014 PECOS PAC ID: 7618123399 Enrollment ID: I20130402000258 |
| Provider Name | Bryan Yang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962701581 PECOS PAC ID: 4880907336 Enrollment ID: I20150714000012 |
| Provider Name | Gagan D Mall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083714919 PECOS PAC ID: 3274539531 Enrollment ID: I20160115002332 |
| Provider Name | Erica Metu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861938623 PECOS PAC ID: 1052687902 Enrollment ID: I20171020003116 |
| Provider Name | Adam Ruggle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417367186 PECOS PAC ID: 3870849607 Enrollment ID: I20190128003429 |
| Provider Name | Doan Q Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336503838 PECOS PAC ID: 0143584599 Enrollment ID: I20191002002125 |
| Provider Name | Victoria Esso Omson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548989965 PECOS PAC ID: 6507234473 Enrollment ID: I20221128000219 |
| Provider Name | Ben M Emeruwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588390629 PECOS PAC ID: 4183080435 Enrollment ID: I20230511003470 |
| Provider Name | Sriram Ramaswamy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174570311 PECOS PAC ID: 8426085994 Enrollment ID: I20230623001048 |
| Provider Name | Fernando Rodriguez Vega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477279578 PECOS PAC ID: 4688033996 Enrollment ID: I20230705002111 |
| Provider Name | Omorogiuwa Maureen Adeneye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770271280 PECOS PAC ID: 9436519279 Enrollment ID: I20230712002229 |
| Provider Name | Matthew Paley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396303756 PECOS PAC ID: 9638557234 Enrollment ID: I20230720003706 |
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