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General NPI Number Information
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NPI Number | 1134277361
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Entity Type | Individual
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Provider Name | JOHN PETER ALENA O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 111 E MAGNOLIA BLVD SEARS BUILDING
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City | BURBANK
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State | CA
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Zip | 91502-1716
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Country | US
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Telephone | 818-559-6661
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Fax | 818-559-7645
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Provider Business Mailing Address
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Address Line | 11260 TERRACERIDGE RD
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City | MOORPARK
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State | CA
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Zip | 93021-3720
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Country | US
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Telephone | 805-532-1944
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Fax | 818-559-7645
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9192T
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License Number State | CA
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