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NPI Code Detail

MEDICARE: ALAN ALEXIS TIRADO

MEDICARE: ALAN ALEXIS TIRADO
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
1106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1194652768
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALAN ALEXIS TIRADO
Provider Business Mailing Address
First Line : 6153 COLGATE AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90036-3127
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1605 W OLYMPIC BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90015-3808
Country : US
Telephone Number : 323-433-4165
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2026
Last Update Date : 05/06/2026

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Directions to “ ALAN ALEXIS TIRADO ” Practice Location

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