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Avalon Medical Development Corporation

Avalon Medical Development Corporation is a health care provider in Avalon, CA. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 100 Falls Canyon Road, Avalon, CA 90704-1563, US
Practice Location Phone310-510-0700
Practice Location Fax310-510-2381
Legal Business NameAVALON MEDICAL DEVELOPMENT CORPORATION
Other Organization NameCATALINA ISLAND MEDICAL CENTER
Other Organization Name TypeDoing Business As Name
NPI ?1346250347
Entity TypeOrganization
Enumeration Date ? Aug 9, 2006
Last Update Date ? Apr 20, 2008
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Avalon Medical Development Corporation

SpecialtySpecializationLicenseLicense State
Clinic/CenterCritical Access Hospital California
Medicare Defined Swing Bed Unit California
Long Term Care Hospital California
General Acute Care HospitalCritical Access California

legacy-id-icon Legacy Provider IDs of Avalon Medical Development Corporation

Provider IdIssuer StateIssuer TypeIssuer
126988ArizonaMedicaid
=========CaliforniaOtherEIN/TIN
RHM03918FCaliforniaMedicaid
ZZT40427GCaliforniaMedicaid
CGP169282CaliforniaMedicaid
HAP03918FCaliforniaMedicaid
ZZT30427GCaliforniaMedicaid
LTC55187GCaliforniaMedicaid
11732369ColoradoMedicaid

official-icon Authorized Official of Avalon Medical Development Corporation

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Avalon Medical Development Corporation's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Mr. Bryan M Ballard (FACHE)
Authorized Official Title/PositionCHIEF EXECUTIVE OFFICER
Authorized Official Phone Number310-510-0700