Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | DC | |
N | 222Z00000X | Podiatrist | DC | |
N | 213E00000X | Podiatrist | 95-3369810 | CA |
N | 222Z00000X | Podiatrist | 95-3369810 | CA |
N | 224P00000X | Prosthetist | DC | |
Y | 224P00000X | Prosthetist | 95-3369810 | CA |
NPI | 1295766020 |
---|---|
Provider Name | Mr. Alejandro Joseph Freire |
First Address | Whittier, CA 90602-1626 |
Second Address | Whittier, CA 90602-1626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 22/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0164940001 | (02) | CA |
4767 | VENDOR FOR CCS (01) | CA |
GFC00150 | (05) | CA |