Provider Demographics
NPI:1568723633
Name:MCALISTER, MIRLO GUILIANA (RN, PHN)
Entity Type:Individual
Prefix:
First Name:MIRLO
Middle Name:GUILIANA
Last Name:MCALISTER
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S COMMONWEALTH AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-4018
Mailing Address - Country:US
Mailing Address - Phone:213-785-4568
Mailing Address - Fax:
Practice Address - Street 1:600 S COMMONWEALTH AVE STE 800
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-4018
Practice Address - Country:US
Practice Address - Phone:213-785-4568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA725916163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management