Provider Demographics
NPI:1023578903
Name:SYKES, ALEXANDRA VAIO (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:VAIO
Last Name:SYKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-8425
Mailing Address - Country:US
Mailing Address - Phone:619-543-6268
Mailing Address - Fax:619-543-6529
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8425
Practice Address - Country:US
Practice Address - Phone:619-543-6268
Practice Address - Fax:619-543-6529
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA178166207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA178166OtherBOARD CERTIFICATION