Provider Demographics
NPI:1780078246
Name:IBARRA, ALEJANDRO (MD)
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:IBARRA
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:UNIVERSITY OF ARIZONA HEALTH SCIENCES CENTER
Mailing Address - Street 2:PO BOX 245114
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724
Mailing Address - Country:US
Mailing Address - Phone:520-626-7141
Mailing Address - Fax:
Practice Address - Street 1:1400 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5906
Practice Address - Country:US
Practice Address - Phone:805-739-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA161854207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology