Provider Demographics
NPI:1235497611
Name:DAVID ALONSO, MD INC
Entity Type:Organization
Organization Name:DAVID ALONSO, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-965-9900
Mailing Address - Street 1:564 RIO LINDO AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1852
Mailing Address - Country:US
Mailing Address - Phone:530-965-9900
Mailing Address - Fax:530-965-9265
Practice Address - Street 1:564 RIO LINDO AVE STE 102
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1852
Practice Address - Country:US
Practice Address - Phone:530-965-9900
Practice Address - Fax:530-965-9265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X
CAA112504261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D2283386OtherCLIA
CA1467403246Medicaid