Provider Demographics
NPI:1952919763
Name:JOHN G. ALEVIZOS, D.O., A PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:JOHN G. ALEVIZOS, D.O., A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:ALEVIZOS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-916-3600
Mailing Address - Street 1:1530 EAST EDINGER AVENUE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705
Mailing Address - Country:US
Mailing Address - Phone:714-442-0400
Mailing Address - Fax:714-542-0038
Practice Address - Street 1:1530 EAST EDINGER AVENUE
Practice Address - Street 2:SUITE 1
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705
Practice Address - Country:US
Practice Address - Phone:714-442-0400
Practice Address - Fax:714-542-0038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty