Healthcare Provider Details

I. General information

NPI: 1427598572
Provider Name (Legal Business Name): ALECTO WHEELING PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2017
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 PLAZA DR
SAINT CLAIRSVILLE OH
43950-6700
US

IV. Provider business mailing address

16310 BAKE PKWY SUITE 200
IRVINE CA
92618-4684
US

V. Phone/Fax

Practice location:
  • Phone: 740-695-5200
  • Fax:
Mailing address:
  • Phone: 949-783-3976
  • Fax: 949-783-3987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SARRAO
Title or Position: CEO
Credential:
Phone: 949-783-3976