Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 13191T | CA |
NPI | 1013035443 |
---|---|
Provider Name | Dr. Brian Rex Alcalde |
First Address | Anaheim, CA 92806-3840 |
Second Address | La Puente, CA 91744-1137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 13/07/2015 |