Provider Demographics
NPI:1750837993
Name:TONELLI, ALYSSA (DO)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:TONELLI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-2304
Mailing Address - Country:US
Mailing Address - Phone:714-426-5400
Mailing Address - Fax:
Practice Address - Street 1:1400 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-2304
Practice Address - Country:US
Practice Address - Phone:714-426-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6061207Q00000X
CA15215207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine