Healthcare Provider Details

I. General information

NPI: 1144586801
Provider Name (Legal Business Name): JULIO ALEJANDRO LAMPREA-MONTEALEGRE M.D M.P.H
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2012
Last Update Date: 01/22/2023
Certification Date: 01/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 MISSION BAY BLVD S
SAN FRANCISCO CA
94143-2156
US

IV. Provider business mailing address

535 MISSION BAY BLVD S
SAN FRANCISCO CA
94143-2156
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2528
  • Fax: 415-353-2873
Mailing address:
  • Phone: 415-353-2873
  • Fax: 415-353-2528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA169328
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: