Provider Demographics
NPI:1851990402
Name:SKWARCAN, ALINA (CPO)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:SKWARCAN
Suffix:
Gender:F
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12200 WASHINGTON BLVD STE M
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-2579
Mailing Address - Country:US
Mailing Address - Phone:562-945-4920
Mailing Address - Fax:562-945-9360
Practice Address - Street 1:12200 WASHINGTON BLVD STE M
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2579
Practice Address - Country:US
Practice Address - Phone:562-945-4920
Practice Address - Fax:562-945-9360
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
224P00000X
CAO006200222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGXC000190OtherMEDICAL