Provider Demographics
NPI:1558454207
Name:AALAEI, SOPHIE SZEWCZYK (MD)
Entity Type:Individual
Prefix:
First Name:SOPHIE
Middle Name:SZEWCZYK
Last Name:AALAEI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SOPHIE
Other - Middle Name:
Other - Last Name:SZEWCZYK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:444 W C ST STE 444
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-3597
Mailing Address - Country:US
Mailing Address - Phone:619-533-4100
Mailing Address - Fax:
Practice Address - Street 1:444 W C ST STE 444
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-3597
Practice Address - Country:US
Practice Address - Phone:619-533-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058183A207ZP0102X, 208VP0014X, 207QA0401X, 207QA0000X, 207Q00000X, 207QA0505X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200911300Medicaid
IN200911300Medicaid
IN199090OMedicare PIN
IN200550MMedicare PIN