Healthcare Provider Details

I. General information

NPI: 1366027682
Provider Name (Legal Business Name): ALONDRA NICOLE ZALOMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2021
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 W 66TH ST
LOS ANGELES CA
90047-2010
US

IV. Provider business mailing address

1450 W 66TH ST
LOS ANGELES CA
90047-2010
US

V. Phone/Fax

Practice location:
  • Phone: 323-767-9621
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: