MEDICARE: MR. RALPH ANTHONY ALCAZAR

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1689860561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RALPH ANTHONY ALCAZAR

Provider Business Mailing Address
First Line	:	201 N K ST
Second Line	:
City	:	TULARE
State	:	CA
Zip	:	93274-4005
Country	:	US
Telephone Number	:	559-687-0929
Fax Number	:	559-685-8953

Provider Business Practice Location Address
First Line	:	201 N K ST
Second Line	:
City	:	TULARE
State	:	CA
Zip	:	93274-4005
Country	:	US
Telephone Number	:	559-687-0929
Fax Number	:	559-685-8953

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2007
Last Update Date	:	09/24/2007

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