Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A24510 | CA |
NPI | 1174638258 |
---|---|
Provider Name | Dr. Alexander Eugene Loscialpo |
First Address | Los Alamitos, CA 90720-3338 |
Second Address | Los Alamitos, CA 90720-3338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 12/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A24007 | (02) | CA |