Healthcare Provider Details

I. General information

NPI: 1194838516
Provider Name (Legal Business Name): ANDREW J ALONGI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 01/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 E 8TH ST SUITE 101
NATIONAL CITY CA
91950-2800
US

IV. Provider business mailing address

6255 SPRUCE LAKE AVE
SAN DIEGO CA
92119-3345
US

V. Phone/Fax

Practice location:
  • Phone: 619-779-7905
  • Fax: 619-779-7906
Mailing address:
  • Phone: 619-205-1485
  • Fax: 619-205-1406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG19454
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: