Provider Demographics
NPI:1770612699
Name:ALANIS, RUDOLPH GARCIA (OD)
Entity type:Individual
Prefix:DR
First Name:RUDOLPH
Middle Name:GARCIA
Last Name:ALANIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10768 NUTMEG CIR
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92337-7653
Mailing Address - Country:US
Mailing Address - Phone:714-473-7449
Mailing Address - Fax:
Practice Address - Street 1:44139 MONTEREY AVE STE A
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-8700
Practice Address - Country:US
Practice Address - Phone:760-469-5195
Practice Address - Fax:760-779-0801
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT12788TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACW532ZMedicare PIN