Provider Demographics
NPI:1104817071
Name:ALLELO & ASSOCIATES
Entity type:Organization
Organization Name:ALLELO & ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HILARION
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMAYUGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-784-5440
Mailing Address - Street 1:9808 VENICE BLVD
Mailing Address - Street 2:SUITE 706
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-2732
Mailing Address - Country:US
Mailing Address - Phone:310-994-8804
Mailing Address - Fax:310-839-1247
Practice Address - Street 1:26303 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-3521
Practice Address - Country:US
Practice Address - Phone:310-784-5440
Practice Address - Fax:310-784-5448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALTC55028F314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC55028FMedicaid
CALTC55028FMedicaid