Provider Demographics
NPI:1386654168
Name:DALMENDRAY, ALINA AMPARO (MD)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:AMPARO
Last Name:DALMENDRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALINA
Other - Middle Name:DALMENDRAY
Other - Last Name:BORCHARDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361-0188
Mailing Address - Country:US
Mailing Address - Phone:805-739-3215
Mailing Address - Fax:
Practice Address - Street 1:1400 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5906
Practice Address - Country:US
Practice Address - Phone:805-739-3215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48599208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F29937Medicare UPIN
UTF29937Medicare UPIN