Healthcare Provider Details

I. General information

NPI: 1295766020
Provider Name (Legal Business Name): ALEJANDRO JOSEPH FREIRE C.P.,B.O.C.O
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 09/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7633 GREENLEAF AVE
WHITTIER CA
90602-1626
US

IV. Provider business mailing address

7633 GREENLEAF AVE
WHITTIER CA
90602-1626
US

V. Phone/Fax

Practice location:
  • Phone: 562-698-0988
  • Fax: 562-696-8791
Mailing address:
  • Phone: 562-698-0988
  • Fax: 562-696-8791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number95-3369810
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number95-3369810
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number StateDC
# 4
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: