Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 296596 | CA |
N | 2251S0007X | Physical Therapist - Sports | 296596 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | 296596 | CA |
NPI | 1184282865 |
---|---|
Provider Name | Alexander Allos |
First Address | Chula Vista, CA 91910-3502 |
Second Address | El Cajon, CA 92019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2019 |
Last Update Date | 29/05/2019 |