Basic Information
| Provider Information | |||||||||
| NPI: | 1588924641 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARES | ||||||||
| FirstName: | ALANNA | ||||||||
| MiddleName: | DOROTHY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2414 T ST | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958167204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165818208 | ||||||||
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| Practice Location | |||||||||
| Address1: | 215 W BEAMER ST | ||||||||
| Address2: | |||||||||
| City: | WOODLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956952510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5304052900 | ||||||||
| FaxNumber: | 5302045255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2012 | ||||||||
| LastUpdateDate: | 05/14/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208000000X | A128746 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.