Provider Demographics
NPI:1396009411
Name:FLORANTE A. ALEJO, M.D., INC.
Entity Type:Organization
Organization Name:FLORANTE A. ALEJO, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORANTE
Authorized Official - Middle Name:ANTOLIN
Authorized Official - Last Name:ALEJO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-830-9962
Mailing Address - Street 1:282 E SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-6323
Mailing Address - Country:US
Mailing Address - Phone:310-830-9962
Mailing Address - Fax:310-518-5912
Practice Address - Street 1:282 E SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-6323
Practice Address - Country:US
Practice Address - Phone:310-830-9962
Practice Address - Fax:310-518-5912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37227261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA84988Medicare UPIN