1265415376 NPI number — DR. JOHN C. ALEMAN MD

Table of content: DR. JOHN C. ALEMAN MD (NPI 1265415376)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265415376 NPI number — DR. JOHN C. ALEMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALEMAN
Provider First Name:
JOHN
Provider Middle Name:
C.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265415376
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
195 AVIATION WAY
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
WATSONVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95076-2059
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
831-728-8250
Provider Business Mailing Address Fax Number:
831-707-2777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
45 NIELSON STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WATSONVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95076-2468
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-728-0222
Provider Business Practice Location Address Fax Number:
831-707-2777
Provider Enumeration Date:
11/22/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  G40852 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00G408520 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00G408520 . This is a "BLUE SHIELD OF CA PIN" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 033286 . This is a "BOARD CERT #" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".