Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 49233 | CA |
N | 213EG0000X | General Practice | 49233 | CA |
Y | 1223P0700X | Prosthodontist | 49233 | CA |
NPI | 1235280025 |
---|---|
Provider Name | Dr. Alejandro Jose Urdaneta |
First Address | Ladera Ranch, CA 92694-1081 |
Second Address | Laguna Hills, CA 92653 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 14/02/2017 |