MEDICARE: USIEL ALCANTAR

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1619649647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	USIEL ALCANTAR

Provider Business Mailing Address
First Line	:	145 N N ST STE A
Second Line	:
City	:	TULARE
State	:	CA
Zip	:	93274-4249
Country	:	US
Telephone Number	:	559-687-8713
Fax Number	:	844-368-4079

Provider Business Practice Location Address
First Line	:	145 N N ST STE A
Second Line	:
City	:	TULARE
State	:	CA
Zip	:	93274-4249
Country	:	US
Telephone Number	:	559-687-8713
Fax Number	:	844-368-4079

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

Provider Enumeration Date	:	09/28/2021
Last Update Date	:	04/01/2025

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Directions to “ USIEL ALCANTAR ” Practice Location

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