Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A127373 | CA |
Y | 2080P0202X | Pediatric Cardiologist | A127373 | CA |
NPI | 1174882385 |
---|---|
Provider Name | Dr. Ryan Earl Alanzalon |
First Address | San Diego, CA 92120-3315 |
Second Address | San Diego, CA 92120-3315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2012 |
Last Update Date | 30/11/2021 |