Healthcare Provider Details

I. General information

NPI: 1053291963
Provider Name (Legal Business Name): ADRIAN ALONZO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2355 N OXNARD BLVD
OXNARD CA
93036-2065
US

IV. Provider business mailing address

3649 LAGUNA RD
OXNARD CA
93033-2201
US

V. Phone/Fax

Practice location:
  • Phone: 805-485-1991
  • Fax:
Mailing address:
  • Phone: 805-366-8189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91238
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: