MEDICARE: ALEJANDRA DUARTE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	A138049	CA

General Provider Information

NPI Number	:	1073920583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRA DUARTE M.D.

Provider Business Mailing Address
First Line	:	5200 CLARK AVENUE # 371
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90714-9998
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	445 E ANAHEIM ST
Second Line	:
City	:	WILMINGTON
State	:	CA
Zip	:	90744-4600
Country	:	US
Telephone Number	:	562-277-9476
Fax Number	:	424-417-5101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2014
Last Update Date	:	11/25/2022

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