Alex Ivan Lara

Primary specialty

Magnetic Resonance Imaging Radiologic TechnologistTaxonomy code 2471M1202X

Practice address

13527 Crape Myrtle Dr
Moreno Valley, CA 92553-4396

Phone

(951) 421-5678

Fax

(951) 421-5678

NPI assigned

Feb 13, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1558068213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13527 CRAPE MYRTLE DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534396",
            "telephone_number": "951-421-5678",
            "fax_number": "951-421-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13527 CRAPE MYRTLE DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534396",
            "telephone_number": "951-421-5678",
            "fax_number": "951-421-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "ALEX",
        "middle_name": "IVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471M1202X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James P Lampasi, DDS
• Landmark Medical Services
• Michel'Le Lane
• Nolan S Langford
• Susana T Lara Lopez
• Sarah Drew Lara, LCSW
• Kathlyn Tatiana Larco, PA-C
• Dajzia Largaespada
• Kali Larsen
• Diana Kay Larson, PAC

• Magnetic Resonance Imaging Radiologic Technologist in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Magnetic Resonance Imaging Radiologic Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.