Provider Demographics
NPI:1215989009
Name:ALCALA, GLORIA (MD)
Entity type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:
Last Name:ALCALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:G
Other - Last Name:ALCALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1332 PARK ST
Mailing Address - Street 2:SUITE #202
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4545
Mailing Address - Country:US
Mailing Address - Phone:510-523-3417
Mailing Address - Fax:510-521-1659
Practice Address - Street 1:1332 PARK ST
Practice Address - Street 2:SUITE #202
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4545
Practice Address - Country:US
Practice Address - Phone:510-523-3417
Practice Address - Fax:510-521-1659
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG078896208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics