Provider Demographics
NPI:1457199127
Name:ALANIS, REBECCA ELIZABETH
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ELIZABETH
Last Name:ALANIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 S GRAND AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3075
Mailing Address - Country:US
Mailing Address - Phone:213-745-4060
Mailing Address - Fax:833-643-1772
Practice Address - Street 1:1513 S GRAND AVE STE 310
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3075
Practice Address - Country:US
Practice Address - Phone:213-745-4060
Practice Address - Fax:833-643-1772
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA1457199127207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program