Provider Demographics
NPI:1134226558
Name:STRESINO, ALTHEA CELIA (MD)
Entity type:Individual
Prefix:DR
First Name:ALTHEA
Middle Name:CELIA
Last Name:STRESINO
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 7169
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91510-7169
Mailing Address - Country:US
Mailing Address - Phone:818-434-0679
Mailing Address - Fax:
Practice Address - Street 1:7107 REMMET AVE
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-2016
Practice Address - Country:US
Practice Address - Phone:818-340-3570
Practice Address - Fax:818-702-9578
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA628332080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH52550Medicare UPIN