Provider Demographics
NPI:1073920583
Name:DUARTE, ALEJANDRA (MD)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:DUARTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALEJANDRA
Other - Middle Name:
Other - Last Name:NAVARRO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5200 CLARK AVENUE # 371
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90714-9998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:445 E ANAHEIM ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-4600
Practice Address - Country:US
Practice Address - Phone:562-277-9476
Practice Address - Fax:424-417-5101
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA138049208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty