Basic Information
Provider Information
NPI: 1245696897
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEONARD ALIBRIO
FirstName: AMBER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4101 TORRANCE BLVD
Address2: EMERGENCY DEPARTMENT
City: TORRANCE
State: CA
PostalCode: 905034607
CountryCode: US
TelephoneNumber: 3105407676
FaxNumber:  
Practice Location
Address1: 4101 TORRANCE BLVD
Address2: EMERGENCY DEPARTMENT
City: TORRANCE
State: CA
PostalCode: 905034607
CountryCode: US
TelephoneNumber: 3105407676
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/12/2016
LastUpdateDate: 04/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X95000356CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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