Provider Demographics
NPI:1578707535
Name:PULDE, ALONA (MD, LAC)
Entity Type:Individual
Prefix:
First Name:ALONA
Middle Name:
Last Name:PULDE
Suffix:
Gender:F
Credentials:MD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 N VISTA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-5743
Mailing Address - Country:US
Mailing Address - Phone:323-876-3600
Mailing Address - Fax:
Practice Address - Street 1:532 N VISTA ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-5743
Practice Address - Country:US
Practice Address - Phone:323-876-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7672171100000X
CAA102345207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine