Healthcare Provider Details

I. General information

NPI: 1962607697
Provider Name (Legal Business Name): PATRICK LOUIS ALORE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 02/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16130 VENTURA BLVD STE 100
ENCINO CA
91436-2517
US

IV. Provider business mailing address

2N070 BERNICE AVE
GLEN ELLYN IL
60137-3104
US

V. Phone/Fax

Practice location:
  • Phone: 818-933-2020
  • Fax: 818-933-0303
Mailing address:
  • Phone: 630-217-8120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA121139
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: