Basic Information
| Provider Information | |||||||||
| NPI: | 1851449847 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALIMENTO | ||||||||
| FirstName: | KENNETH | ||||||||
| MiddleName: | U | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 441 N LAKEVIEW AVE | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928073028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8889882800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 441 N LAKEVIEW AVE | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928073028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8889882800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2007 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | OPT9670TPA | CA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.