Basic Information
| Provider Information | |||||||||
| NPI: | 1265779706 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COMMUNITY HEALTH FOR ASIAN AMERICANS | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| OtherOrganizationName: | EDNA BREWER | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1141 HARBOR BAY PARKWAY | ||||||||
| Address2: | #105 | ||||||||
| City: | ALAMEDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108352777 | ||||||||
| FaxNumber: | 5108350164 | ||||||||
| Practice Location | |||||||||
| Address1: | 3748 13TH AVE | ||||||||
| Address2: | |||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946102820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5108792100 | ||||||||
| FaxNumber: | 5108792109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2013 | ||||||||
| LastUpdateDate: | 09/19/2017 | ||||||||
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| AuthorizedOfficialLastName: | YU | ||||||||
| AuthorizedOfficialFirstName: | CHEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 5108352777 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.