Provider Demographics
NPI:1982633160
Name:CONFORTO, ALESSANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALESSANDRA
Middle Name:
Last Name:CONFORTO
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 1:355 FREEMAN AVE
Mailing Address - Street 2:APT. #6
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-5727
Mailing Address - Country:US
Mailing Address - Phone:562-433-8378
Mailing Address - Fax:
Practice Address - Street 1:1300 W 7TH ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-3505
Practice Address - Country:US
Practice Address - Phone:310-514-5350
Practice Address - Fax:310-514-5421
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64742207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A647420Medicaid
CA00A647420Medicaid
CAWA64742DMedicare PIN