Provider Demographics
NPI:1790817328
Name:UMALI, MARIA SANDRA ALZONA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA SANDRA
Middle Name:ALZONA
Last Name:UMALI
Suffix:
Gender:F
Credentials:MD
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 221360
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91322-1360
Mailing Address - Country:US
Mailing Address - Phone:661-964-0597
Mailing Address - Fax:661-964-0598
Practice Address - Street 1:22621 LYONS AVE
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-1702
Practice Address - Country:US
Practice Address - Phone:661-964-0597
Practice Address - Fax:661-964-0598
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34940207RG0100X, 207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D1000027OtherCLIA
CA05D1000027OtherCLIA
CAE01619Medicare UPIN
CAA34940Medicare PIN