Basic Information
| Provider Information | |||||||||
| NPI: | 1033843792 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KORHELY-DAY | ||||||||
| FirstName: | ALEXANDRIA | ||||||||
| MiddleName: | NOELLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8652 FESTIVAL ST | ||||||||
| Address2: | |||||||||
| City: | CHINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917088882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9514861632 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1556 S SULTANA AVE | ||||||||
| Address2: | |||||||||
| City: | ONTARIO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917614238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094186923 | ||||||||
| FaxNumber: | 9094186937 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2022 | ||||||||
| LastUpdateDate: | 07/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
ID Information
| ID | Type | State | Issuer | Description | 19631475 | 01 | CA | KAISER | OTHER |