MEDICARE: ALLELO & ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	LTC55028F	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104817071
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLELO & ASSOCIATES

Provider Business Mailing Address
First Line	:	9808 VENICE BLVD
Second Line	:	SUITE 706
City	:	CULVER CITY
State	:	CA
Zip	:	90232-2732
Country	:	US
Telephone Number	:	310-994-8804
Fax Number	:	310-839-1247

Provider Business Practice Location Address
First Line	:	26303 WESTERN AVE
Second Line	:
City	:	LOMITA
State	:	CA
Zip	:	90717-3521
Country	:	US
Telephone Number	:	310-784-5440
Fax Number	:	310-784-5448

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. HILARION DIMAYUGA
Credential	:
Telephone Number	:	310-784-5440

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	11/14/2024

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