Healthcare Provider Details

I. General information

NPI: 1457779837
Provider Name (Legal Business Name): YILIEN ALONSO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10752 N 89TH PL STE C134
SCOTTSDALE AZ
85260-7902
US

IV. Provider business mailing address

3260 N HAYDEN RD STE 112
SCOTTSDALE AZ
85251-6650
US

V. Phone/Fax

Practice location:
  • Phone: 480-860-1990
  • Fax: 480-860-1887
Mailing address:
  • Phone: 602-264-9100
  • Fax: 602-264-9101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number76518
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: