Provider Demographics
NPI:1174306963
Name:ALONZO, JOSEPH A
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:ALONZO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N PALM CANYON DR # A1-A4
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-1868
Mailing Address - Country:US
Mailing Address - Phone:760-424-5602
Mailing Address - Fax:
Practice Address - Street 1:2500 N PALM CANYON DR # A1-A4
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-1868
Practice Address - Country:US
Practice Address - Phone:760-424-5602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist