Provider Demographics
NPI:1508230756
Name:FRANK M. DALESSANDRO MD INC
Entity Type:Organization
Organization Name:FRANK M. DALESSANDRO MD INC
Other - Org Name:OCEAN PACIFIC PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:HAMILTON
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-334-3105
Mailing Address - Street 1:11741 VALLEY VIEW ST. STE A
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630
Mailing Address - Country:US
Mailing Address - Phone:714-897-1071
Mailing Address - Fax:714-373-4696
Practice Address - Street 1:11741 VALLEY VIEW ST STE A
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-5500
Practice Address - Country:US
Practice Address - Phone:714-897-1071
Practice Address - Fax:714-799-2096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-25
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty