Healthcare Provider Details

I. General information

NPI: 1033439328
Provider Name (Legal Business Name): KAREN BRENDA ALONSO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11022 N 28TH DR STE 270
PHOENIX AZ
85029-5639
US

IV. Provider business mailing address

5555 W. THUNDERBIRD BANNER THUNDERBIRD MEDICAL CENTER
GLENDALE AZ
85306
US

V. Phone/Fax

Practice location:
  • Phone: 623-404-8505
  • Fax:
Mailing address:
  • Phone: 602-865-2627
  • Fax: 602-865-2632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number47925
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR72082
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number47925
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: