MEDICARE: J. ANTONIO ALARCON, MD INC

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	208800000X	Urology Physician	A401970	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	:	1558502716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J. ANTONIO ALARCON, MD INC

Provider Business Mailing Address
First Line	:	PO BOX 303
Second Line	:
City	:	SURFSIDE
State	:	CA
Zip	:	90743-0303
Country	:	US
Telephone Number	:	714-375-6280
Fax Number	:

Provider Business Practice Location Address
First Line	:	2133 W BEVERLY BLVD
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-3901
Country	:	US
Telephone Number	:	323-201-5200
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	KATHY LYNN EMERZIAN
Credential	:
Telephone Number	:	714-375-6280

Provider Enumeration Date	:	03/18/2009
Last Update Date	:	03/18/2009

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