Healthcare Provider Details

I. General information

NPI: 1235945502
Provider Name (Legal Business Name): DALLAS MATTHEW ALANIZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7755 LEEDS ST
DOWNEY CA
90242-3489
US

IV. Provider business mailing address

7755 LEEDS ST
DOWNEY CA
90242-3489
US

V. Phone/Fax

Practice location:
  • Phone: 562-719-2867
  • Fax:
Mailing address:
  • Phone: 562-719-2867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: