Healthcare Provider Details

I. General information

NPI: 1154373207
Provider Name (Legal Business Name): DR. PERPETUA ALEGRADO LAWAS-ALEJO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 S SUNSET AVE
WEST COVINA CA
91790-3937
US

IV. Provider business mailing address

5374 SHEMIRAN ST
LA VERNE CA
91750-2378
US

V. Phone/Fax

Practice location:
  • Phone: 626-813-3716
  • Fax:
Mailing address:
  • Phone: 909-392-8458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA52878
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: