MEDICARE: IRENE ELIZABETH ALANIZ NP

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	95011135	CA

General Provider Information

NPI Number	:	1962963140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRENE ELIZABETH ALANIZ NP

Provider Business Mailing Address
First Line	:	431 INDIANA ST APT S
Second Line	:
City	:	EL SEGUNDO
State	:	CA
Zip	:	90245-5832
Country	:	US
Telephone Number	:	818-720-5187
Fax Number	:

Provider Business Practice Location Address
First Line	:	852 S ROBERTSON BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-1601
Country	:	US
Telephone Number	:	917-410-6905
Fax Number	:

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

Provider Enumeration Date	:	03/29/2019
Last Update Date	:	03/19/2022

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