| Gustavo A Alza Md A Medical Corporation | |
|
5224 N Figueroa Street Los Angeles CA 90042-4118 | |
| (323) 259-0456 | |
| (323) 259-8486 |
| Full Name | Gustavo A Alza Md A Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 5224 N Figueroa Street, Los Angeles, California |
| Authorized Official Name and Position | Gustavo Alberto Alza (CORPORATE PRESIDENT) |
| Authorized Official Contact | 3232590456 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gustavo A Alza Md A Medical Corporation 5224 N Figueroa Street Los Angeles CA 90042-4118 Ph: (323) 259-0456 | Gustavo A Alza Md A Medical Corporation 5224 N Figueroa Street Los Angeles CA 90042-4118 Ph: (323) 259-0456 |
| NPI Number | 1174605612 |
|---|---|
| Provider Enumeration Date | 10/20/2006 |
| Last Update Date | 02/27/2015 |
| Medicare PECOS PAC ID | 7719955079 |
|---|---|
| Medicare Enrollment ID | O20110124000614 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174605612 | NPI | - | NPPES |
| DB6615 | Other | CA | RAILROAD MEDICARE # |
| 00G487490 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G48749 (California) | Primary |
| Provider Name | Gustavo A Alza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942498464 PECOS PAC ID: 6507045531 Enrollment ID: I20120210000636 |
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