Basic Information
| Provider Information | |||||||||
| NPI: | 1457354136 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | D'ALESSANDRO | ||||||||
| FirstName: | FRANCESCO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD-PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2865 DAGGETT AVE | ||||||||
| Address2: | |||||||||
| City: | KLAMATH FALLS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 976011106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5095253720 | ||||||||
| FaxNumber: | 5095221592 | ||||||||
| Practice Location | |||||||||
| Address1: | 3000 BRYANT WILLIAMS DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | KLAMATH FALLS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 976011139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412748908 | ||||||||
| FaxNumber: | 5412748908 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2005 | ||||||||
| LastUpdateDate: | 06/09/2016 | ||||||||
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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 | 174400000X | A 86773 | CA | N | Other Service Providers | Specialist | 207N00000X | MD60085709 | WA | N | Allopathic & Osteopathic Physicians | Dermatology | 207N00000X | MD151399 | OR | Y | Allopathic & Osteopathic Physicians | Dermatology |
ID Information
| ID | Type | State | Issuer | Description | MD151399 | 01 | OR | STATE OF OREGON | OTHER |