Healthcare Provider Details

I. General information

NPI: 1003302282
Provider Name (Legal Business Name): ANA ALONZO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 04/07/2023
Certification Date: 04/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 ZONAL AVE
LOS ANGELES CA
90033-1026
US

IV. Provider business mailing address

2010 ZONAL AVE # 5P47
LOS ANGELES CA
90033-1026
US

V. Phone/Fax

Practice location:
  • Phone: 323-409-3680
  • Fax: 323-226-8114
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95022803
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number818356
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: