Healthcare Provider Details

I. General information

NPI: 1366327892
Provider Name (Legal Business Name): RAYMOND ALZATE BSN, RN, CNOR, RNFA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 N ROSE DR
PLACENTIA CA
92870-3802
US

IV. Provider business mailing address

7325 EL DOMINO WAY APT 2
BUENA PARK CA
90620-2642
US

V. Phone/Fax

Practice location:
  • Phone: 714-993-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number95320271
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: