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General NPI Number Information
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NPI Number | 1174099782
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Entity Type | Organization
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Legal Business Name | ALEGRIA FAMILY MEDICAL CLINIC
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Dates
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Enumeration Date | 10/22/2018
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Last Update Date | 11/07/2019
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Provider Practice Location Address
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Address Line | 1315 N BULLIS RD STE 6
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City | COMPTON
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State | CA
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Zip | 90221-1662
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Country | US
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Telephone | 310-554-4870
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Fax | 310-554-4359
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Provider Business Mailing Address
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Address Line | 1315 N BULLIS RD STE 6
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City | COMPTON
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State | CA
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Zip | 90221-1662
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Country | US
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Telephone | 310-554-4870
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Fax | 310-554-4359
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Authorized Official
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Title or Position | NP
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Name | JOY O EGWU
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Credential | FNP, DNP
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Telephone | 310-554-4870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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