Wilfredo Alejo, M.D.
Individual provider Active NPI Pediatrics Physician · Diamond Bar, CA
NPI 1114990785 · NPPES record last updated Oct 14, 2021
Key facts
- NPI
- 1114990785
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- A52629 (CA)
- Practice address
- 1514 Valley Vista Dr
Diamond Bar, CA 91765 - Phone
- (909) 860-1144
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110106000849 | CA | Practitioner - Pediatric Medicine | 5092904037 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (7 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current |
Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current |
Accepting new patients | |
| St Jude Hospital Inc | Past | Accepting new patients | |
| San Dimas Community Hospital, Inc. | Past | Accepting new patients | |
| Emanate Health Medical Center | Past | Accepting new patients | |
| Emanate Health Medical Center | Past | Accepting new patients |
Locations
200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841
253 S Diamond Bar Blvd
Diamond Bar, CA 91765
Phone (909) 860-1144
1514 Valley Vista Dr
Diamond Bar, CA 91765
Phone (909) 560-1144
100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200
4300 Rose Dr
Yorba Linda, CA 92886
Phone (714) 528-4211
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A52629 | CA | Yes |
Addresses
Primary practice location
1514 Valley Vista Dr
Diamond Bar, CA 91765
Mailing address
1514 Valley Vista Dr
Diamond Bar, CA 91765-3929
Other practice location 1
420 W Rowland St
Covina, CA 91723-2943
Phone (626) 331-6411
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | walejo1373454@oc.providencedirect.org |
Other providers in Diamond Bar, CA
- Anas Al-Qazzaz
- Al-Sayed MD Inc
- Alaa Hajal MD
- Albers Family Counseling
- Albertsons LLC
- Alireza Halati, MD Medical Corporation
- Varun Uthappa Allaranda Ganapathy
- Silvia Alonzo
- Nadia Alvarez
- Jessica Amador-Castellanos
All providers in Diamond Bar, CA · Pediatrics Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.