Provider Demographics
NPI:1962242578
Name:IROHA, ALEX (NP)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:IROHA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10121 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-3228
Mailing Address - Country:US
Mailing Address - Phone:213-334-4243
Mailing Address - Fax:323-215-0170
Practice Address - Street 1:14625 CARMENITA RD STE 201
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-5263
Practice Address - Country:US
Practice Address - Phone:213-334-4243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95147147363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner