Provider Demographics
NPI:1871789149
Name:ADVANTAGE HEALTH NETWORK INC
Entity type:Organization
Organization Name:ADVANTAGE HEALTH NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:KIMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-562-6170
Mailing Address - Street 1:5953 ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90270-3133
Mailing Address - Country:US
Mailing Address - Phone:323-562-6170
Mailing Address - Fax:323-561-6176
Practice Address - Street 1:5953 ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90270-3133
Practice Address - Country:US
Practice Address - Phone:323-562-6170
Practice Address - Fax:323-561-6176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty