Healthcare Provider Details

I. General information

NPI: 1457748089
Provider Name (Legal Business Name): ALEJANDRO PINO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2015
Last Update Date: 08/26/2021
Certification Date: 08/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 SANTA FE DR STE 100
ENCINITAS CA
92024-5157
US

IV. Provider business mailing address

420 E 70TH ST APT 4L3
NEW YORK NY
10021-5354
US

V. Phone/Fax

Practice location:
  • Phone: 760-230-8994
  • Fax:
Mailing address:
  • Phone: 305-898-1646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA172405
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA172405
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: