Provider Demographics
NPI:1629487970
Name:BRITO, ALMA
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:
Last Name:BRITO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10395
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92711-0395
Mailing Address - Country:US
Mailing Address - Phone:714-368-0871
Mailing Address - Fax:714-368-0872
Practice Address - Street 1:1621 E 17TH ST
Practice Address - Street 2:#I
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8518
Practice Address - Country:US
Practice Address - Phone:714-368-0871
Practice Address - Fax:714-368-0872
Is Sole Proprietor?:No
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD4612672172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver