Provider Demographics
NPI:1992295331
Name:ALERA INC
Entity type:Organization
Organization Name:ALERA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF CLINICAL OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KESHAVARZI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:619-371-4222
Mailing Address - Street 1:2667 CAMINO DEL RIO S STE 307-6
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3707
Mailing Address - Country:US
Mailing Address - Phone:619-371-4222
Mailing Address - Fax:619-371-4223
Practice Address - Street 1:2667 CAMINO DEL RIO S STE 307-6
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-371-4222
Practice Address - Fax:619-371-4223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-11
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty