Healthcare Provider Details

I. General information

NPI: 1174628325
Provider Name (Legal Business Name): ALFONSO L BARRAGAN MD FACS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 S ATLANTIC BLVD STE 302
MONTEREY PARK CA
91754-4785
US

IV. Provider business mailing address

880 S ATLANTIC BLVD STE 302
MONTEREY PARK CA
91754-4785
US

V. Phone/Fax

Practice location:
  • Phone: 626-281-8835
  • Fax: 626-281-1526
Mailing address:
  • Phone: 626-281-8835
  • Fax: 626-281-1526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA29368
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA29368
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: