Individual provider Active NPI

Lazaro Victor Alonso, M.D.

  • Specialist
  • Van Nuys, CA
National Provider Identifier
1427073576
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
15216 Vanowen St
Van Nuys, CA 91405-3601
Phone
(818) 785-7875
Fax
(818) 909-7924
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

15216 Vanowen St
Van Nuys, CA 91405-3601

Mailing address

15216 Vanowen St
Van Nuys, CA 91405-3601
Phone (818) 785-7875

Other identifiers 1

IdentifierTypeStateIssuer
00A393430MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39343CAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1427073576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15216 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053601",
            "telephone_number": "818-785-7875",
            "fax_number": "818-909-7924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15216 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914053601",
            "telephone_number": "818-785-7875",
            "fax_number": "818-909-7924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALONSO",
        "first_name": "LAZARO",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A393430",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.