Provider Demographics
NPI:1083701411
Name:HINOJOSA, ALEJANDRO G (MD)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:G
Last Name:HINOJOSA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 120490
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91912-3590
Mailing Address - Country:US
Mailing Address - Phone:619-216-7546
Mailing Address - Fax:619-216-7783
Practice Address - Street 1:340 4TH AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-3813
Practice Address - Country:US
Practice Address - Phone:619-216-7546
Practice Address - Fax:619-216-7783
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69515207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A695150Medicaid
CA00A695150Medicaid
CAY05877Medicare UPIN