Provider Demographics
NPI:1194259317
Name:ALECTO EAST OHIO PHYSICIANS, INC.
Entity type:Organization
Organization Name:ALECTO EAST OHIO PHYSICIANS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SARRAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-783-3976
Mailing Address - Street 1:16310 BAKE PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4684
Mailing Address - Country:US
Mailing Address - Phone:949-783-3976
Mailing Address - Fax:949-783-3987
Practice Address - Street 1:2000 EOFF ST
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3823
Practice Address - Country:US
Practice Address - Phone:304-234-0123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty