Provider Demographics
NPI:1376601831
Name:GENEST, ALORIA STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALORIA
Middle Name:STEPHEN
Last Name:GENEST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:A.
Other - Middle Name:STEPHEN
Other - Last Name:GENEST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, FICS
Mailing Address - Street 1:2870 EL RANCHO DR.
Mailing Address - Street 2:
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95060
Mailing Address - Country:US
Mailing Address - Phone:831-438-7111
Mailing Address - Fax:831-438-7710
Practice Address - Street 1:2870 EL RANCHO DR.
Practice Address - Street 2:
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95060
Practice Address - Country:US
Practice Address - Phone:831-438-7111
Practice Address - Fax:831-438-7710
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC26000174400000X
CAC-26000207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA3018Medicare UPIN
CA00C260000Medicare PIN