Healthcare Provider Details

I. General information

NPI: 1427561935
Provider Name (Legal Business Name): ANDRES ALEGRIA DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 11/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE
SAN FRANCISCO CA
94143-2202
US

IV. Provider business mailing address

4359 EDGEWOOD AVE
OAKLAND CA
94602-1315
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1756
  • Fax:
Mailing address:
  • Phone: 510-367-9694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT292091
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: