Provider Demographics
NPI:1669621058
Name:ALONSO, ALBERTO (MD)
Entity type:Individual
Prefix:MR
First Name:ALBERTO
Middle Name:
Last Name:ALONSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10436 DOWNEY AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241
Mailing Address - Country:US
Mailing Address - Phone:562-881-3043
Mailing Address - Fax:323-815-1827
Practice Address - Street 1:6611 SEVILLE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255
Practice Address - Country:US
Practice Address - Phone:562-881-3043
Practice Address - Fax:323-815-1827
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA102197207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty