MEDICARE: MRS. DOROTHY ADHIAMBO ALFORD FNP

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	363LF0000X	Family Nurse Practitioner	NP95008257	CA

General Provider Information

NPI Number	:	1578058525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DOROTHY ADHIAMBO ALFORD FNP

Provider Business Mailing Address
First Line	:	3903 CONQUISTA AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-2215
Country	:	US
Telephone Number	:	661-874-3094
Fax Number	:

Provider Business Practice Location Address
First Line	:	3756 SANTA ROSALIA DR STE 320
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-3615
Country	:	US
Telephone Number	:	323-292-5600
Fax Number	:

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

Provider Enumeration Date	:	06/22/2018
Last Update Date	:	06/22/2018

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