Provider Demographics
NPI:1003001991
Name:ALEXANDER E LOSCIALPO MD INC
Entity Type:Organization
Organization Name:ALEXANDER E LOSCIALPO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:LOSCIALPO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-378-2480
Mailing Address - Street 1:3801 KATELLA AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3338
Mailing Address - Country:US
Mailing Address - Phone:714-378-2480
Mailing Address - Fax:562-594-8832
Practice Address - Street 1:3801 KATELLA AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3338
Practice Address - Country:US
Practice Address - Phone:714-378-2480
Practice Address - Fax:562-594-8832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24510207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24007Medicare UPIN
CAW857Medicare PIN