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General NPI Number Information
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NPI Number | 1578786547
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Entity Type | Organization
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Legal Business Name | RANDALL R. ALESSI OD, INC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 02/09/2010
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Provider Practice Location Address
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Address Line | 25401 ALICIA PKWY STE. E
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-4958
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Country | US
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Telephone | 949-951-8001
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Fax | 949-951-1552
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Provider Business Mailing Address
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Address Line | 25401 ALICIA PKWY STE. E
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-4958
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Country | US
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Telephone | 949-951-8001
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Fax | 949-951-1552
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Authorized Official
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Title or Position | DOCTOR OWNER
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Name | DR. RANDALL RALPH ALESSI
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Credential | OD
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Telephone | 949-951-8001
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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 | 8651T
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License Number State | CA
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