Provider Demographics
NPI:1467403246
Name:ALONSO, DAVID G (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:ALONSO
Suffix:
Gender:M
Credentials:MD
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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
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2023-01-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH12929207R00000X
CAA112504207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1467403246Medicaid
CA1235497611Medicaid
NH30212766Medicaid
CAP00889088OtherRR MEDICARE
CA1467403246Medicare NSC
NHRE8697Medicare PIN